Illustration by Abigail Gray Swartz
My husband fills out most of the forms in our marriage. So when we received a humongous packet of forms at a kindergarten prematriculation session, he immediately got to work. Hunched over the voluminous pile, he meticulously yet mindlessly checked little boxes and filled in the blanks. But a question I just happened to glance caught my attention:
Type of birth: Vaginal ______________ Cesarean ____________
I ripped the form out from under his pen. Why he was answering this question? Come to think of it, why was anyone answering it? The “baby” who had resulted from that birth was 5 years old and well over any possible ramifications of it I could imagine.
I thought it was obvious that this question was absurdly inappropriate, and said so. My husband informed me that most forms and their questions are poorly formatted, redundant, and/or unnecessary, which is why I always make him do them — and also why he didn’t give this particular question a second thought. But this question is especially intrusive and irrelevant, I insisted. It reminded me of some awful blind date asking if the carpet matched the drapes. My vagina was not up for discussion by a stranger then, and it’s certainly not up for public examination now. I had to know: Why would they even ask?
I called the number listed on the form, and it eventually led me to a meeting with the head nurse and a call with the district’s outside medical adviser. The head nurse informed me that the form was stored in the school nurse’s files so that if a teacher or other administrator perceives an issue with a child (presumably, a learning disability or behavioral problem), that person could pull the file and look for clues in the medical record that might explain the cause.
I asked how birthing methods would be relevant, and she responded that a cord wrapped around the neck depriving a child of oxygen or fetal distress could lead to developmental problems. That seemed both far-fetched and inadequate to me. If adverse birth events are the underlying concern, why not ask about them? Birth trauma can occur regardless of delivery type. And why not ask about other possible medical explanations for kindergarten challenges? Shouldn’t they, I asked, include the question about whether a child is vegan so a teacher can look for vitamin deficiencies? “We don’t like to ask questions about food,” she said. “Parents are very sensitive to that.” But questions about our vaginas are A-OK!
When I spoke with the medical adviser to the district, he told me “type of birth” is one of the most common questions to ask on a form. Perhaps at a doctor’s office, I suggested, but not on a kindergarten application. In response, he told me I was the first person to ever bring it up and that he filled out the same form over 20 years ago when his children went to kindergarten. Such parental nostalgia might support a remake of “Gilligan’s Island,” but scarcely provides support for an intrusive question on an exhaustive questionnaire that is used only in rare circumstances.
There are plenty of questions that could be germane to a child’s medical, safety and educational assessment but are generally considered too insensitive, nosy or politically toxic to pose. Where are the questions like, “Do you have any firearms in your house?” or “Please list all controlled substances prescribed to members of the household and details of how they are stored.” I think I would have been chagrined by any number of obnoxious questions on the kindergarten application, but I’m still confused by why the birth query made the cut. Perhaps it is because we are so used to answering that particular question that we don’t stop to think about what it means to have it asked in this context.
If a pediatrician asks this question in private practice, it affects only that doctor’s patients, and all responses are protected by the privacy rules of the Health Insurance Portability and Accountability Act of 1996. Additionally, one would expect the question to be followed up by more insightful and medically relevant questions.
But when it is asked on a school form, the information is protected only by the exception-riddled Family Educational Rights and Privacy Act law, and how it is used is entirely up to the individual reading it. Misused and misinterpreted information is worse than useless, and it’s unlikely to help anyone. Unless evidence-based medicine or pedagogy shows the type of birth to be valuable for assessing a child’s current health, ability to learn, or safety, or whether it poses a medical or security risk to others, why should I respond?
Because I never received a satisfactory response from my school district, I decided to boycott the health history form altogether. So far, no repercussions (although I suppose it’s possible there is now a different note about my son’s mother in his file).
IT’S A CONVERSATION ABOUT MUCH MORE THAN ABORTION
In many discussions of reproductive health, which is the focal point of so much high-profile political and interpersonal unrest lately, the subtext seems to so often be “ABORTIONS AND SEX. UNPROTECTED HETERO SEX…AND ABORTIONS. SAFE (HETERO) SEX? SIN?” The whole complex systems of what else bodies of all formations can do are obfuscated, in favor of concentrating on the potential implications of using only a very few parts of them for strictly P-in-V sex. This is dangerous and unfounded. While performing the totally delightful disappearing act on the reality of gender and sexual identities that are not cis and/or hetero, this mode of thinking also shunts aside that there’s a WHOLE LOT MORE going on inside (and outside) all of us! No matter what you believe about sex and abortion, it’s crucial to your well-being, body-wise and brain-wise, to grasp the full extent of what’s being dismissed when people zero in on boning and abortion as representative of all reproductive health.
Planned Parenthood, a network of around 700 nonprofit health centers that offers free and low-cost reproductive medical care throughout the U.S. and in 13 other countries, is a good model for thinking about this. The same reductive logic that mars reproductive health discourse is frequently applied specifically to their organization, which provides abortions among its many services. For a lot of people, abortion is a huge thing to think about! Please believe that I know. Still, in a Planned Parenthood 2015 report, abortions accounted for only three percent of all the medical procedures and services they provided. (There’s some contention about this statistic, but those who oppose it make the argument that, because abortions can be more expensive than other procedures, they’re “more” than one procedure, or something? Nah.). When it comes to both reproductive health and Planned Parenthood, there are lots of other big deals we need to be accounting for and considering, too.
Outside of that three percent, Planned Parenthood’s care is predominantly based in disease and infection treatment and prevention (42 percent of services) [This and the other percentages I’m about to cite are on page 19 of this PDF]; providing contraception (34 percent of services; Planned Parenthood estimates that this prevented over 500,000 unintended pregnancies last year); cancer screenings and prevention, like breast and gynecological examinations (nine percent; and let’s not forget that breast cancer is the number-one most common cancer among women, andthe second-most common cause of death by cancer among women); and offering other assorted healthcare and education about sex, health, and family planning to its patients, which are predominantly female—though men are treated at Planned Parenthood—and include adolescents and teenagers (you!). Planned Parenthood is also a resource for trans patients: Its mission is to offer inclusive care, information, and advice to all people, and 10 states now have at least one Planned Parenthood center that offers hormone treatments to people who are transitioning. Over five million people, of all genders and a multitude of ages and experiences, make use of Planned Parenthood in one or more of these many ways per year.
OK, so now that we know that reproductive health—and Planned Parenthood—covers so many more body-based goings-on than just abortion, here’s why it’s extra-crucial to think critically about the ways Planned Parenthood is represented by its detractors: Seventy-eight percent of those millions of people who use Planned Parenthood are very poor. We’re talking at and below 150 percent of the federal poverty level. And that line is lowww, babies—look at the way it breaks down right here. For many low-income people, Planned Parenthood is a “primary care” provider, meaning: It’s the only way for them to see a doctor of any kind. Numerous Planned Parenthoods around the country have accounted for this, and offer general services like physicals, vaccines, and screenings for different kinds of illness and disease.
Because the media often myopically focuses on Planned Parenthood–as–abortion provider, rather than acknowledging its full and robust range of services, it’s easy for people on the whole to do the same. As such, Planned Parenthood is currently the public and political scapegoat for those who oppose women’s right to choose. Because Planned Parenthood is not-for-profit, they receive an essential portion of their funding from the federal government. This bill angles to defund Planned Parenthood (and overturn/weaken a number of other public healthcare initiatives that are essential and irreplaceable for poor people, like Medicaid, a form of insurance for low-income Americans). Earlier this month, the Senate voted to pass it. It won’t become law this time, because President Obama has made it clear he’s really not about to let any legislature defunding Planned Parenthood or overturning the Affordable Care Act happen, but there will be a next time, and a time after that, where politicians try to strip women and their allies of basic health rights in this respect, and others.
A brief reminder: Defunding Planned Parenthood would not stop women from getting abortions—or, it wouldn’t stop women who had the financial means to go to a private clinic, anyway. Effectively, this decision would do little more than widen the gap between the health-based privileges of low-income women and those who live more comfortably. It implies—and enacts—that the lives of poor women are expendable. The outcome of defunding Planned Parenthood, in all this political bloviating about abortion, is that people who cannot afford to go anywhere else for life-changing and -saving medical treatment will lose that healthcare.
There is destruction borne of the anti-abortion political movement right now, regardless of what laws are passed, too. Increasingly, when it comes to Planned Parenthood, abortion is not the sole focus of the conversation, but it’s not because there’s so much more that they do for people. Instead, Planned Parenthood makes news because its centers and employees have become a quite literal target for extremists who disagree with a woman’s right to terminate a pregnancy, and to a lethal degree. One demonstration of this: Did you know that, in the span of under four months this year, there were four arsons at Planned Parenthoods across the country? And of course you’ve heard about the November shooting at a Planned Parenthood in Colorado that left three people dead and nine injured. At a court hearing, the killer, Robert Lewis Dear, Jr. made his motives clear by yelling:
This man was convinced that his assassination of three people was the protection of life.
A logic against abortion, and specifically Planned Parenthood, that boils down to “killing babies” is not new to me, though. It scares me that I’ve heard this propaganda stated near-to-verbatim by people whose brains I trust and love. Last month, I sat down with Madeline, my 21-year-old sister. We talked about everything that siblings who are also very tight friends do: fast food, jobs, clothes, pit bull mixes, love, family, sex. These last three topics came together when, offhandedly, I mentioned something that I guess sounded favorable about Planned Parenthood.
“You LIKE them?” Maddy asked, looking shocked and chagrined
“Yeah, of course I like Planned Parenthood. They help a lot of people who need it. How do you feel about what they do?”
“They abort babies when they’re, like, fully developed—and sell their body parts,” Maddy said. “It’s horrible. They kill babies. You believe in that?”
“You watched those videos, too, huh? They were awful—they made me sick,” I said. “Can we talk about what we actually saw in them, though?”
I imagined many people had had similar discussions to ours since July, when the first in a series of videos made by an an anti-abortion group calling itself “The Center for Medical Progress” and smearing Planned Parenthood came out. The former organization claimed to prove that the latter performs abortions in order to sell fetuses. After pulling up statistics on my phone showing Maddy that only 1.4 percent of legal abortions are performed after 21 weeks of pregnancy, andonly in cases where pregnancy poses extreme health risks, we looked into the facts: Planned Parenthood’s doctors donate tissue to scientific research groups, and how fetal tissue has been used to develop vaccines and other cures for diseases. Planned Parenthood does not profit from this arrangement. They receive small sums from the groups they work with in order to pay for only the transportation and related costs of getting samples from clinics to labs intact.
You’d never know this from watching the video, in which two members of the CMP posed as a scientific research group looking to receive tissue donations from Planned Parenthood. In secretly shot footage, they lasso Planned Parenthood’s senior director of medical services, Deborah Nucatola, into discussing the organization’s policies about medical donations. The video was edited so that all of what she says appears to be the fees that Planned Parenthood needs per sample—$30 to $100, which is just enough to cover those costs we talked about earlier—without including the rest of her context, making it look like Planned Parenthood is selling what many commentators referred to as the babies’ “body parts” for profit. (The CMP has since released the full, unedited video, but it’s not the one that went wildly viral.) She goes on to say, “Affiliates are not looking to make money by doing this. They’re looking to serve their patients and just make it not impact their bottom line.” In regular-person language: Planned Parenthood’s goal is to donate tissue without losing money. “No one’s going to see this as a money-making thing,” Nucatola continues.
On that tip of “No one’s going to see this as a money-making thing”: OH MY GOD, DEB, HOW I WISH YOU HAD BEEN RIGHT. The highly edited footage and pursuant commentary from anti-abortion politicians characterized Planned Parenthood as the opposite of what it is: Instead of a hugely needed source of support for people whose lives would be debilitated or even threatened without the healthcare Planned Parenthood gives them, it was (and continues to be) portrayed as a bloodthirsty, money-snatching band of monsters selling the “body parts” of babies. I felt gross just WRITING that sentence—it’s a horrible concept. Thank god it is not what’s actually going on.
This is not what many people will tell you, though, despite what the facts are. At a debate between Republican presidential candidates in September, multiple speakers claimed that Planned Parenthood “murdered” babies, even after it was clear that footage of a stillborn baby had been erroneously presented as “harvested” by Planned Parenthood in order to inspire hatred against them. How disgusting is that? And it works: Last month, after the Colorado Springs attacks, the CEO and President of Planned Parenthood Rocky Mountains, who oversees where the shooting took place, said, “We’ve seen an alarming increase in hateful rhetoric and smear campaigns against abortion providers and patients over the last few months. That environment breeds acts of violence. […] We should not have to live in a world where accessing health care includes safe rooms and bulletproof glass.”
Compare that statement to the rhetoric of current Texas Senator and 2016 presidential candidate Ted Cruz, who, in response to the shootings, chose to try and pin Dear’s homicides to trans people. Days after the shooting, he lied, “We don’t fully know the motivations of this deranged individual,” and continued, “We know he was a man who registered to vote as a woman. The media promptly wants to blame him on the pro-life movement when, at this point, there’s very little evidence to indicate that. […] It’s also been reported that he was registered as an independent and a woman and transgendered leftist activist, if that’s what he is.”
Cruz used hateful rhetoric to wrongfully associate trans people, who are already intensely discriminated against, with terrorism that was actually based in extreme pro-life beliefs, regardless of any verifiable knowledge of Dear’s gender identity—which is NOT to say that it matters in the slightest, but that certain conservative interest groups’ propensity for lying about these issues is boundless. The politicians who use the “proof” of the videos’ fabrications are so often the same ones who blithely and aggressively fuck up on race, class, and gender in their messaging and legislative actions. To push the CMP’s misinformative drivel as fact in order to capitalize on the hearts of people who simply do not want to hurt children, no matter the human or sociological cost of at-risk identities and classes, is mesmeric in its moral bankruptcy.
The vitriol about who’s profiting off of defenseless life is being lobbed at an organization trying to provide for those who are hurt and oppressed by the very people whose actions are hurting and oppressing them—not to mention working against their own supposed interests. The estimated number of abortions circumvented thanks to Planned Parenthood’s prevention of unwanted pregnancies, per year, is over 217,000. That is what people attacking clinics are actually attacking, in addition to rights and justice and human life: Abortion prevention.
The kind of reasoning behind this display of hatred has never been about “the babies.” If it were, politicians and their supporting constituents who oppose abortion wouldn’t undercut and preclude legislation that provides childcare for poor families (blocked), prevents child hunger(blocked), and public programs funding education (rather, check out this total gut-wrenching partytime of a bill where the GOP has tried to drastically cut federal funding to the 33 biggest school districts, with the biggest populations of black and Latino students). If it were truly about protecting infants and kids, Republicans would throw their weight behind any number of child-helping initiatives instead of killing legislature that aids or nurtures them.
So if it’s not about the babies…what is it about? It’s about the money, and it’s about the women. Namely, it’s about disenfranchising and controlling poor and nonwhite women by taking away the services that help elevate their quality of life while leaving them bereft of support systems.
This means agitating for “reproductive justice,” a term which means the ability of all people to access equal health care and have the right to safely decide their own treatments for their own bodies, can never succeed if that movement is not intersectional to its core. In a recent interview, the writer and editor Doreen St. Félix brilliantly reframed the intersection of these issues by calling attention to institutionalized racial violence: “Police brutality is a reproductive health crisis. If pro-choice means the right to have children, then it should also mean that those children should be able to live. I’ve found that black and brown women […] are positioned such that we know what unaffordable childcare, poor housing, red-lining, unequal employment, and the list goes on, can take from health.” In looking at health-based justice, we need to see that the privileged people who are curtailing reproductive well-being for women are curtailing lives that they deem irrelevant to their power in so many other respects, and that needs to be a part of the conversations we have about this.
In this present moment that is so fraught with dominant groups vying to decimate everyone else’s rights, it can be hard to know where to expend whatever amount of energy you have when it comes to issues that are called “political,” but are in fact frightening, tangible threats against real people. The solution is not co-opting voices and social justice movements to the singular goal of talking about one medical procedure (abortion), no matter how important it very much is, but working together to see where all kinds of reproductive health initiatives and so many other social issues connect to and can lift one another, as Doreen St. Félix did in that interview. This means looking critically at the quality of life, safety, and dearth of resources for all people, and recognizing the role of organizations like Planned Parenthood within that. There’s a lot to talk about here! No matter what your beliefs are, you deserve to have those conversations based on facts. ♦
A word from your Editrix :
Hi everybody. Welcome to Trans.Lives.Style, The Authentic You, a new wide reaching blog about arts, culture, opinion and health from the perspective of a trans woman, Danielle Sylvie. My friends call me Sylvie, and that’s a long story for the future. As an independent consultant and designer, I am, like many of you, striving to live an authentic life of independent strength, honesty, style– and glamour. I invite you to join this forum.
The word ‘Lifestyle’ for many in the LGBTQ community has been fraught with challenging politics. Let me be clear that we never won the culture war to convince that biology determinism would magically transform acceptance. We are lucky nonetheless to be living in a time of such great diversity in society, our laws, our families, our jobs, our places of worship, our schools, our arts and entertainment – everywhere we express (or repress) our authentic selves. A few words on repression and justice below.
More to the point, I don’t care which side you are on concerning nature versus nurture. I personally am on both sides. I do want to know how you think, how you express yourselves, what your style is, and how you live your lives.
Last time I checked, the American Constitution protects, among many things, Speech, Creed, & Worship. If you believe you were born LGBTQ or Q; or just want to put on a pretty dress, it is your god- and law-maker given right to express your ‘lifestyle’ personally and among consenting peoples. I am deeply interested in social justice and the challenges and dangers we all face in our daily lives – and I am probably not the best woman to report it first-hand. Without delving into too many topics yet, thank you Laverne Cox for reminding everyone who interviews her the triumphs and perils of trans women , particularly of color, beyond her own personal success – everyone just trying to live authentic lives.
All the Lives Matter movements is why I need your stories; Opinion & Ideas will be as important as Style – every facet of how & why you express yourselves.
Of equal importance… to carry ourselves strongly in an uncertain world; to look and to be fabulous.
So strike your best Power Pose (Amy Cuddy, my starfishes, https://www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are?language=en)
Please join me in the conversation.