Trigger Warning for medical neglect and abuse, police abuse, and discussions of the child welfare system

The St. Louis Post-Dispatch reports:

Anna Brown wasn’t leaving the emergency room quietly.

She yelled from a wheelchair at St. Mary’s Health Center security personnel and Richmond Heights police officers that her legs hurt so badly she couldn’t stand.

She had already been to two other hospitals that week in September, complaining of leg pain after spraining her ankle.

This time, she refused to leave.

A police officer arrested Brown for trespassing. He wheeled her out in handcuffs after a doctor said she was healthy enough to be locked up.

Brown was 29. A mother who had lost custody of two children. Homeless. On Medicaid. And, an autopsy later revealed, dying from blood clots that started in her legs, then lodged in her lungs.

She told officers she couldn’t get out of the police car, so they dragged her by her arms into the station. They left her lying on the concrete floor of a jail cell, moaning and struggling to breathe. Just 15 minutes later, a jail worker found her cold to the touch.

Officers suspected Brown was using drugs. Autopsy results showed she had no drugs in her system.

Six months later, family members still wonder how Brown’s sprained ankle led to her death in police custody, and whether anyone — including themselves — is to blame.

The way the Post-Dispatch exploits family members’ personal sense of guilt that is a normal part of grieving, equating it with much larger forces, would have you believe that Anna Brown’s death was just a tragic accident. But the way Brown died was not the result of a few bad choices. It was the result of a myriad of institutional violences: white supremacy, the broken health care system, police brutality and the prison industrial complex, the racism and classism of the child welfare system, ableism and its intersection with racism, dehumanization and criminalization of (suspected) drug users, and the lack of housing as a human right, among others. Anna Brown did not die with the dignity we afford to human beings, but with the contempt we reserve for garbage. And a woman’s humanity is not just forgotten and cast aside with no systemic reason.

The institutional violence against Anna Brown began long before her death from an undiagnosed yet treatable condition, and her death can only be understood within the context of this long string of abuses.

Anna Brown was one of 10 children. She graduated from Kirkwood High School. At 18, she had her first child, a boy. She had a daughter nine years later. Brown was raising them alone when a tornado destroyed her north St. Louis home on New Year’s Eve 2010. She moved to Berkeley.

Shortly after, she lost her job at a sandwich shop. Bills lapsed. The electricity was turned off. So was the gas. And the water.

Family members say Brown and her children appeared fine during visits at Davis’ home in Normandy.

They weren’t.

In April, a state Children’s Division representative found Brown’s toilet filled with feces. Burn marks scarred the floors and sinks where Brown had used small fires to stay warm. One refrigerator could not be opened. Insects and rotting food filled another, according to state reports given to the Post-Dispatch by Brown’s family.

Brown was not lucid and seemed confused as Berkeley police arrested her for parental neglect. The courts awarded legal custody of the kids to the Children’s Division. Davis could have physical custody, as long as Brown didn’t live with her.

Brown’s home was condemned. She ended up on the streets. She lived in four homeless shelters from May to September 2011.

At first, she visited her children at her mother’s home. That ended in June, when Brown started telling the children they didn’t have to listen to their grandparents and called the police to report they were being abused. Police found no evidence of abuse.

After that, Brown had supervised visits with her children at the Children’s Division. She also called her mother daily to check on them.

Brown, who later started receiving treatment for mental illness, is just one of countless examples of the way that the child welfare system is an active agent of racism, classism, ableism, and sexism. Earlier assistance could have easily prevented the loss of necessary utilities like heat and water, could have kept food in the fridge, could have provided mental health services to Brown if needed, could have helped her care for her children. This crisis almost certainly could have been avoided.

But as Dorothy Roberts shows in her incredible and important book Shattered Bonds: The Color of Child Welfare, the system sees these means of assistance as undeserved, and either refuses to provide them or makes access to them overly burdensome. Indeed, the child welfare system, instead of acting to keep families healthy, works mainly as a means of social control of Black populations. While Native and Latino children are also generally overrepresented in the child welfare system, the overwhelming majority of children are Black — in some cities, virtually all are Black. Virtually all also come from families that are poor. And the vast majority of cases are not of the kind of child abuse we see on the news, but of “neglect.” As Roberts explains, “neglect” generally means being poor — not having access to adequate food, shelter, or child care. But as in Brown’s case, the system does not give beds to families when it deems they do not have enough, does not provide housing vouchers when they see shelter as inadequate, does not increase food stamp allotment when children are going hungry, or provide child care when parents cannot afford it but still have to work. The child welfare system instead almost always acts too late, and has only one means of intervention: removing the children from their parents, who are usually mothers.

Brown’s children were not only removed from her, but explicitly forbidden from living with her, even when another adult in the household was acting as their carer, even though there was no evidence that she posed a physical danger or threat to her children. The system deliberately acted not just to keep the children safe and cared for, but to keep mother and children apart. In the child welfare system, separating Black children from their mothers is seen as the only means to keep them safe, even when other options are clearly available.

Further, once the children were provided for, the system lost interest in Brown’s own well-being. Like so many poor people of color with mental illness(es), she was not given housing and access to mental health services, but instead ended up homeless — a state which only exacerbates existing mental illness, and would be incompatible with reuniting her with her children. And after this series of assaults on Brown’s rights and humanity, it is her mother who is left feeling the guilt for forcibly complying with an abusive system:

Davis also faults the St. Louis County Family Court, which she said forced her into a heartbreaking dilemma after the state took away Brown’s children on a claim of neglect. Davis could take in her grandchildren or her daughter, a judge said, but not both.

“I’m mad at myself because if I hadn’t listened to the courts, she would still be here,” Davis said. “If she had been here at this house, she would be here today.”

Anna Brown attempted to access health care from the position of a Black homeless woman who had been deemed an “unfit mother” and who was perceived as “mentally unstable.”  The social forces of white supremacy, classism, misogyny, and ableism ensured that she therefore entered this system, a site in which innumerable oppressions are enacted, as someone perceived as far less than fully human. If homeless people are inhuman, if being an unfit mother is close to the worst thing a woman can be, if being Black is both criminalized and associated with worse health care outcomes across the board, if “crazy” people are to be either feared or ignored, this inevitably impacted the care that she received.

Despite repeatedly complaining of the same symptoms, Brown was not believed. The medical staff in charge did their tests, and decided that they knew better than Brown about her own body. Instead of reviewing their work — ultrasounds were apparently conducted to check for blood clots — or searching for alternate explanations, they decided that Brown must be lying, perhaps looking for drugs. This call was irrefutably tied to Brown’s race, gender, homelessness, and mental health status. Real-life medicine doesn’t work like House. But if anyone thinks an insured white guy with no history of mental illness would have been pinned with “drug-seeking behavior” and literally dragged away in handcuffs, they’re living in one hell of a different United States of America than I am.

Anna Brown was arrested for demanding medical care for a condition that killed her several hours later. For seeing herself as deserving of life, for knowing that her constant pain was not normal or acceptable, for demanding that somebody give a damn and recognize her humanity, she was thrown in jail and died alone on a cold cement floor. An officer waited for three hours with Brown to see a doctor who could declare her “fit for confinement,” so that he could drag her from a police car when she could not walk. Who devoted those same levels of time and resources to saving her life? Who cared as much about why this homeless Black woman was in so much pain and distress as they did about locking her up?

Both the police and the hospital have shirked responsibility:

St. Mary’s officials say they did all they were supposed to do for Brown. “Our records show that, in this case, everything that should have been done medically was done properly. We found nothing that would have changed this tragic outcome,” according to a statement.

Police Chief Maj. Roy Wright said his officers had no way of knowing Brown’s condition. “A lot of times people don’t want to stay in jail and will claim to be sick,” he said. “We depend on medical officials to tell us they’re OK.”

We found nothing that would have changed this tragic outcome.

I am not a doctor. Even if I were, I do not have access to Anna Brown’s medical records. I do not know if the ultrasounds were conducted properly. I do not know if there were additional tests that could or should have been done. I do not know if her condition was not diagnosed because of carelessness and prejudice, or because it simply could not be diagnosed. I do not know how or if Anna Brown could have lived.

But I do know one thing for sure: she did not have to die like she did.

It was not inevitable that she was charged with “trespassing” at a hospital while complaining of a legitimate medical condition. It was not inevitable that her pain was ignored and treated as a fabrication. It was not inevitable that she be literally dragged away in handcuffs because she could not walk and because authorities just needed another Black body locked up. It was not inevitable that she die alone on a cold floor, in a way that we would never wish on animals. It was not inevitable that a homeless Black woman asserting herself was perceived as being “on drugs,” or that being “on drugs” revoked her right to decency and humanity.

I do not know that Anna Brown had to die. But even if she did, she could have died in a hospital bed. She could have been given the same dignity afforded to insured white people who aren’t (actually or perceived as) “crazy” or “on drugs.” She could have not have had her identity as a mentally ill, homeless Black woman equated with criminality and worthlessness. She could have been treated like the human being she was, as a person whose life had value.

And anyone who cannot see that is the one who is actually lacking humanity.

Chances are, this morning, that you’ve seen the new Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control statistics on sexual violence and domestic violence. Most notably, you’ve probably seen the new statistic that almost 1 in 5 women have experienced rape in their lifetimes.

That’s a terrifying statistic, though not a surprising one to those of us who have been involved in sexual violence work for some time. In light of this undeniably already awful news, it may seem cruel to point out that the reality is even worse than it initially appears from this soundbite. But I also think it’s necessary.

Firstly, I think it’s imperative to note that these new statistics are inherently cissexist. Definitions in this report assume that women have vaginas and men have penises. There are no individuals who are neither men nor women. Whether any trans* folks were interviewed for this survey is unclear. They may have been disqualified from participation or had their experiences filed under the incorrect statistics. Trans* folks are mentioned exactly once in the full 124 page National Intimate Partner and Sexual Violence Survey 2010 Summary Report (pdf); it is simply stated that services specifically for transgender people should be designed, with no accompanying information on their experiences or how they have or have not been included in this study. It is almost certain, in other words, that these statistics do not tell us anything about rates of violence against “women” and “men” but rather cis women and cis men.

Secondly, the definition of rape that is used in the NISVS is in one way unconventionally broad. In several other ways, the definition of rape being used is also woefully incomplete. The full sexual violence definitions used for this study appear below.

Five types of sexual violence were measured in NISVS. These include acts of rape (forced penetration), and types of sexual violence other than rape.

Rape is defined as any completed or attempted unwanted vaginal (for women), oral, or anal penetration through the use of physical force (such as being pinned or held down, or by the use of violence) or threats to physically harm and includes times when the victim was drunk, high, drugged, or passed out and unable to consent. Rape is separated into three types, completed forced penetration, attempted forced penetration, and completed alcohol or drug facilitated penetration.

• Among women, rape includes vaginal, oral, or anal penetration by a male using his penis. It also includes vaginal or anal penetration by a male or female using their fingers or an object.
• Among men, rape includes oral or anal penetration by a male using his penis. It also includes anal penetration by a male or female using their fingers or an object.

Being made to penetrate someone else includes times when the victim was made to, or there was an attempt to make them, sexually penetrate someone without the victim’s consent because the victim was physically forced (such as being pinned or held down, or by the use of violence) or threatened with physical harm, or when the victim was drunk, high, drugged, or passed out and unable to consent.

• Among women, this behavior reflects a female being made to orally penetrate another female’s vagina or anus.
• Among men, being made to penetrate someone else could have occurred in multiple ways: being made to vaginally penetrate a female using one’s own penis; orally penetrating a female’s vagina or anus; anally penetrating a male or female; or being made to receive oral sex from a male or female. It also includes female perpetrators attempting to force male victims to penetrate them, though it did not happen.

Sexual coercion is defined as unwanted sexual penetration that occurs after a person is pressured in a nonphysical way. In NISVS, sexual coercion refers to unwanted vaginal, oral, or anal sex after being pressured in ways that included being worn down by someone who repeatedly asked for sex or showed they were unhappy; feeling pressured by being lied to, being told promises that were untrue, having someone threaten to end a relationship or spread rumors; and sexual pressure due to someone using their in?uence or authority.

Unwanted sexual contact is defined as unwanted sexual experiences involving touch but not sexual penetration, such as being kissed in a sexual way, or having sexual body parts fondled or grabbed.

Non-contact unwanted sexual experiences are those unwanted experiences that do not involve any touching or penetration, including someone exposing their sexual body parts, flashing, or masturbating in front of the victim, someone making a victim show his or her body parts, someone making a victim look at or participate in sexual photos or movies, or someone harassing the victim in a public place in a way that made the victim feel unsafe.

So the definition of “rape” includes both completed and attempted rapes. Don’t get excited yet, MRAs — attempted rape is not only an incredibly serious crime, it is also the minority of experience made up under the “rape” 1 in 5 statistic. The table on page 28 of the report shows that 12.3% of cis women reported completed “forced” rape, 8% reported completed alcohol/drug-facilitated rape, and a comparably small 5% reported attempted “forced” rape.¹

Further, the definition of “rape” excludes all other means of rape that do not involve physical force or drugs and alcohol. The above definition of “sexual coercion” would, to most readers here who utilize some form of an enthusiastic or meaningful consent model, also constitute rape.² If we are to include the respondents who reported instances of “sexual coercion” under our definition of rape, the situation gets decidedly worse. A full 13% of cis women reported experiencing sexual coercion. We do not know how how much these numbers overlap with the “rape” statistics presented above. But the report does estimate almost 15.5 million U.S. cis women victims of “sexual coercion.”

(It’s also important to note that not all cis women are equal with regards to sexual violence, either. Cis women who are Native, Black, or identified as multi-racial had significantly higher rates of victimization than women who are white or identified as Hispanic.)

When talking about these numbers, we not only need to note their trans-exclusionary nature, but also their inability to account for the full, meaningful picture. We shouldn’t be saying that almost 1 in 5 U.S. women have been raped when what the information actually shows is that, based on a far more social justice oriented model, more than 1 in 5 cis U.S. women have been raped.

Trigger Warning on post and links for graphic descriptions of sexual violence against sex workers, including sexual torture; rape apologism

This past April, a woman who was doing sex work was picked up by one John Hauff and driven to his home to engage in a pre-negotiated sexual encounter. Hauff requested some bondage elements in that encounter — to which the woman agreed, while setting strong limits.

John Hauff allegedly violated those limits wildly. Instead of loosely tying her to the bedpost and stimulating her with a vibrator, as she says she agreed, he allegedly chained her to the ceiling and forced painful sexual acts on her involving extreme bondage, paddles, electrical shocks, speculums, and catheters.

The first page of this article in the Seattle Weekly offers a lengthy, extremely explicit description of the allegations in question.

The second page goes on to begin (technically in the second paragraph down):

But is John Hauff a monster? Or is there, as some in the bondage community suggest, another way to interpret what happened between John Hauff and the woman he picked up on Aurora Avenue on April 2—one that makes Hauff less a cruel and sadistic rapist than a participant in a bondage session gone haywire?

Rape is not BDSM¹ gone wrong. And what has been alleged is not “BDSM” or “bondage” but rape and sexual torture. Anyone in bondage/BDSM communities making the argument that there is only a thin line between BDSM and rape is doing themselves an incredible disservice. They serve not to speak for the rights of those who wish to engage in consensual, non-mainstream sexual behavior, but for rapists. To conflate BDSM enthusiasts with rapists is to wrongly vilify BDSM and its participants, the vast majority of whom don’t rape people. And it is to suggest that anyone who agrees to any BDSM elements in a sexual situation is more or less requesting to be raped.

As it turns out, though, this article ends up splitting very neatly among gender lines. All of the women consulted in the piece — one who previously engaged in consensual BDSM scenes with Hauff, and the executive director of the Center for Sex Positive Culture — absolutely agree that the allegations as described constitute sexual violence and are utterly unacceptable.

The men who weigh in on the subject are, shockingly, a little bit less sure. One of them is Master Ray, a man who makes his living doing BDSM trainings, and who seems to have rather antiquated views on gender roles.

The other is Jonathan Kaminsky, the author of the piece himself, who sets up this absurd, rape apologist framing on the basis of nothing more than the word of one BDSM practitioner (against the word of two others), and seemingly his own gut instinct about how rape allegations just can’t be trusted. This is despite the fact that Hauff admitted to police that he did not stop the first two times the woman told him to.

The article is supposedly intended to interrogate whether or not Hauff’s “fetish will set him free.” It’s a real possibility, with both rape culture and mainstream views and misunderstandings regarding BDSM being what they are. But Kaminsky doesn’t explore the prejudices of the average public. He doesn’t consult lawyers regarding defense tactics, or speculate on what “expert” witnesses may be called to the stand to act as apologists. He just asks some people who also engage in BDSM what they think of the case. Most of them say “this sounds like rape.” One reads from a rape apologist script. And suddenly, we’re supposed to believe that there is meaningful “controversy” here and reason to entertain the possibility of a gray area.

We’re not supposed to notice that this angle was manufactured by the author, who turned “one guy I talked to” into “some in the bondage community” and closed his article like this:

Only two people know what happened the night of April 2, what boundaries were drawn, what deals were struck, and how, when, and to what degree they were breached. It is possible that their understanding of what happened on that night differs. It’s possible we’ll never know the truth.

…

What we do know is that no bodies were found in his yard, and no other women have come forward with terrible stories of kidnap and rape. We also know this: The events of April 2 have marked a dark chapter in the lives of prostitute and client alike.

Indeed.

Of course, anyone with the slightest familiarity with rape culture will know that “only two people know what happened” is the classic way of saying that we better take the alleged rapist’s word for it. And anyone who knows anything about alt-weeklies that do their damnedest to seem street-smart will also know that the Seattle Weekly editors have absolutely no excuse to not know the term “sex worker” or how the unnecessarily repeated references to the victim in this case as a “prostitute” (instead of a rape victim) are incredibly stigmatizing towards her in the current U.S. cultural climate. And anyone who knows anything about life will know that not having decaying corpses on your property or a long line of highly marginalized victims who are willing to step forward and involve themselves in a very public case hardly means that you didn’t rape that one woman who says you raped her.

But surely we can all agree that this sucks as much for the rapist as it does for the rape victim, can’t we?

Frankly, if this is what passes for objectivity and journalistic ethics these days, I don’t want it.

But back to Master Ray. Well, some of his own views are as terrifying as they are long-winded:

When the subject turns to John Hauff, Master Ray’s face hardens. He’s never met the man, he says, pausing to sip from his glass of milk. He knows only what he’s seen on TV and heard on the radio. Because he doesn’t have all the details, Master Ray cautions that making a judgment “would be improper and foolish.” Still, he says, there’s something about the young woman’s story that troubles him. She acknowledges negotiating up front for a certain amount of bondage, Master Ray points out. She got in his car willingly, and they drove to his place. There was no threat of brutality in the car.

“It wasn’t a kidnapping,” Master Ray says. “It was a negotiated sex scene between a hooker and her client. And somewhere along the line, she crossed her own panic line and cried ‘Help!’ ”

As for her texting of Hauff’s license-plate number, Master Ray points out that this is standard operating procedure in the fetish community, and doesn’t necessarily mean the young woman was unusually leery of Hauff. “We call that a ‘safe call.’ It’s perfectly legitimate and normal,” he says. Once she’d revealed the text message to Hauff, Ray continues, “What happened next? She got dressed. He took her back where she belonged. He dropped her off. There was no threat. No murder. No ‘Keep quiet or I’ll come get you.’ ”

During a bondage session in which the rules have already been agreed upon, a dominant partner’s saying something to arouse a submissive partner is as common as flirting, Master Ray says. If, during a bondage scene, Master Ray were asked by a submissive he didn’t know if he planned to kill her, he would read it as a sign that this type of talk turned her on. “So I’m going to smirk and say something like ‘We’ll see,’ or ‘Maybe later,’ or ‘Only if you’re not pleasing to me, only if you don’t satisfy me,’ ” explains Master Ray. “Call me a smart-ass, but I’m going to say something that is going to elicit a response from her.”

When the prostitute asked Hauff if he was going to kill her, Master Ray says, “We don’t know what tone of voice she used.” Her question, he says, could have been understood as a clue that this form of “danger” was a turn-on for her. “And the worst part of it is that between the time it happened and when she finally decided to report it, her feelings, her thoughts, can change,” Master Ray says. “Shame can set in. And then he gets punished because now she’s feeling bad about it.”

Still, Master Ray acknowledges, Hauff’s alleged use of such techniques as bladder manipulation and electric shock, which are at the outer edges of the bondage-play repertoire, give him pause. “If he did spring this on her, then he crossed a line,” Master Ray says. “That would not be tolerated in the [fetish] community.”

There’s something about the woman’s story that bothers him: namely, that he doesn’t seem to think a woman (let alone “a hooker”) who agrees to any kind of sexual contact can then be raped. The fact that she admittedly cried “Help!” doesn’t count. After all, her rapist didn’t kill her. (Master Ray is wrong about her not being told to keep quiet; Hauff allegedly told the woman to not involve the cops, easily understood as a threat in itself.)

His argument seems to be “this would have been completely consensual, if both parties consented.” Which, obviously. The very point is that one party explicitly says she did not consent. But Master Ray asserts that we don’t know the tone of voice she used when asking if Hauff was going to kill her, so the consent was probably implied.

Personally, I’d say that Master Ray sounds like an incredibly irresponsible and dangerous dom, if his portrayal of how he treats partners he does not know and has not negotiated said elements with in advance is accurate. And yet, we are supposed to respect him as an expert not only in BDSM, but also in consent as it relates to BDSM. As if BDSM communities are somehow uniquely immune to rape culture.

According to Master Ray “the worst part of it” is not that a woman was allegedly raped and tortured, but that she might be lying about it. Which alone should tell us all we need to know about him. The myth that women quickly become “ashamed” of their sexual activity and then falsely claim rape in order to protect their patriarchally-approved virtue is a pervasive if widely debunked one. The fact that said myth is able to be twisted and applied to sex workers — the same women who are routinely portrayed as having no virtue left in a world that judge’s women’s virtue on the basis of their chastity — is nothing more than evidence of how far misogynists are willing to contort their own logic to support men’s right to rape (at least certain) women with impunity.

Indeed, one of the truly remarkable things about this case is that the police care at all. One could indeed speculate that the particular amount of violence used and the non-mainstream sexual acts allegedly forced are likely the reason. In a culture where consensual kinky sex is vilified, rape involving elements that would be considered kinky in a consensual setting will always be more severely demonized. In a culture where sex workers are routinely raped by police, where sex workers are almost always too afraid to report their rapes to police, where judges call the rape of sex workers “theft of services,” it’s not a stretch to imagine that we wouldn’t be seeing the same amount of resources or outrage applied had the woman consented to one kind of sex and then forced into another, with no BDSM elements present. We’d be hearing choruses of “what did she expect?”

Clearly some commenters aren’t content to entirely avoid those choruses now. Some people can’t get past the idea that a woman who agrees to any kind of sex deserves whatever violence might be inflicted on her. This is far more so when the woman in question is a sex worker.

But no matter what the Seattle Weekly or Master Ray sees fit to either imply or outright say, there is no such thing as blanket consent. Every person has the right to say no, to set limits, and to have those limits respected. When those limits are violated, it is assault. No matter what other acts they may have agreed to. No matter who they are.

Thanks to Una Feral for the link.

Arizona legislators are working on a new anti-immigration bill that is essentially the hospital equivalent of their notorious SB 1070. The new bill, SB 1405, would require all hospitals within the state to verify the immigration status of all patients. If a patient cannot prove that sie is in the country legally, hospital staff would be required by law to contact immigration officials.

A new bill making its way through Arizona’s state legislature is drawing a lot of attention. It’s Senate Bill 1405. Some call it the hospital version of SB 1070.

Anyone who has spent a day at Maricopa County Medical Center knows people from all walks of life are wheeled through the halls.

But if a new piece of legislation passes, some of those patients will be wheeled from the emergency room to immigration officials.

If SB 1405 passes, hospitals would be required to check a patient’s citizenship status after administering any emergency medical care.

If the person isn’t in the United States legally, the law would require they be turned over to immigration officials.

Yes, this bill is real. It can be read in full on the Arizona State Legislature’s website, and view the official fact sheet.

Now, the bill itself does not actually require that hospitals refuse treatment to those who are undocumented or cannot prove immigration status. SB 1405 doesn’t go quite that far — at least, in this draft.

But do not be at all mistaken — if passed, an inability to access medical care will be precisely what occurs all the same.

Already, some immigrants, terrified and terrorized by the very real raids and surveillances that are a daily threat to their communities, falsely believe that hospitals are required to check immigration status. As a result, they avoid medical treatment, even when it is dire. People have become very ill, risked their lives, been left with lifelong conditions that would have been treatable earlier, and undoubtedly died. Because there is a war to protect U.S. borders, and undocumented bodies have inevitably been declared its enemy.

If this bill is passed — and with the passage of SB 1070, it is most certainly more than a remote possibility — that situation will be multiplied many times over. People will forced to choose between the dangerousness of refusing medical care and hoping they survive and the dangerousness of interacting with institutions have declared their existence, their very selves to be “illegal.” As now with those who can’t afford care in the U.S. for-profit medical system, serious conditions will be nervously brushed off. Rape victims, victims of intimate partner violence, and women and trans* people who are having pregnancy complications will go without treatment. There will be no such thing as safety. Violence will become even more inescapable than it is now. And people will die.

People will die.

They will die, and this fact — this is not speculation, it is a simple cause and effect analysis, it is a fact — is neither a secret nor a mystery. And clearly, that’s at least part of the point. As KPHO Phoenix reports:

Those in favor of the bill said hospitals shouldn’t be treating people in the country illegally.

They don’t quote a proponent of the bill in support of this statement, but such people are not exactly difficult to find. They are everywhere, asking why should “they” (undocumented immigrants) get to use “our” (U.S.) schools, anyway? Clearly, children whose parents don’t have the right papers do not deserve an education, they do not need to read or add or write. They are seen asking why “they” should be allowed to use “our” police forces. Clearly, some of us deserve access to the institutions generally regarded as the primary means to keep communities safe, some of us deserve to report crimes against us, to not be assaulted and raped, and some of us do not. And they are indeed seen asking why “they” should be allowed to use “our” hospitals — there is a health care crisis already, so how dare they use up resources?

Clearly, some of us deserve to live and some of us deserve to die. Because that is what the ability to access health care comes down to. And those supporting this bill know it.

And then there is this:

Senate President Russell Pearce, a Mesa Republican who was chief sponsor of last year’s immigration law, says the hospitals bill is part of a broader effort to crack down on illegal immigration. The hospitals bill wouldn’t bar people from getting care, but it would put the onus on hospitals to “do due diligence,” Pearce said. “We’re going to enforce our laws without apology.”

Added Pearce: “It’s the law. It’s a felony to (aid and) abet. We’re going to enforce the law without apology.”

This is what happens when we declare people “illegal,” when we start calling them by that slur publicly and officially. If they are illegal, their very lives are illegal. To protect the health and safety of those declared illegal, to afford them the very most basic human rights, to treat them as human beings, becomes a crime.

As ms. radically hott off writes:

How much more savage and vindictive can we be? what other mami will have to choose between the health of her children and a place to live/work? Do you know what that feels like? To see your sick child and know—I’m going to have to take her in? To *dread* getting help for your child? I feel like that all the time because of money—I can’t even imagine the added burden of knowing that you will lose everything because your child has a right to live and be healthy.

Those proposing and supporting this bill don’t even recognize that this right to live and be healthy exists for certain bodies, including those which belong to children. They certainly don’t mind putting it in extraordinary jeopardy.

The bill was originally scheduled to go before the Senate Judiciary Committee yesterday, but was yanked at the last moment due to a lack of votes. The sponsors, however, have stated that they are considering other committees. We have most certainly not seen the last of SB 1405, and with numerous other states considering legislation similar to SB 1070, we are witnessing the mere beginning of a white supremacist resurgence in the U.S. In the general public consciousness, the bars for what constitutes either “extreme” or “racist” have both been raised. Progressives can only ignore efforts like these and assume they will just go away at the risk of people losing not only their homes and incomes and right to be near their families, but also their lives.

Yesterday, I wrote about the horrific case of Kelley Williams-Bolar (pictured left), a woman who has been jailed for ten days and slapped with a felony record — which will prevent her from obtaining her teacher’s license — for sending her children to a school district other than the one they lived in.

My analysis of this unconscionable set of events can be found in the previous post. Today, I just want to draw your attention to a way that you can help Williams-Bolar appeal her case. Via Change.org, Williams-Bolar is working with the National Action Network, and is in need of funds to help her pay the legal fees she will incur in appealing the judge’s verdict.

You can send donations to the National Action Network Akron Chapter, c/o Kelley Williams-Bolar, P.O. Box 4152, Akron, Ohio, 44321. Checks can be made payable to Williams-Bolar.

Please give if you can and help spread this information far and wide.

Last week, a woman was sent to jail for ten days, placed on two years probation, and ordered to complete 80 hours of community service for a felony conviction. Her crime was fudging documents so that she could send her two daughters to the “wrong” school district, in the richer Akron, Ohio suburb where her father lived. She was led away in handcuffs.

On Saturday, a jury found Williams-Bolar guilty on two counts of tampering with records. She was also facing one count of grand theft, but the judge declared a mistrial on that charge after the jury couldn’t reach a verdict.

Williams-Bolar could have been sent to a state prison for up to 10 years, but Judge Cosgrove decided on a 10-day sentence in the Summit County Jail after weighing Williams-Bolar’s lack of criminal record with the seriousness of her crimes.

“I felt that some punishment or deterrent was needed for other individuals who might think to defraud the various school systems,” Cosgrove told NewsChannel5 after the sentencing.

Prosecutors said Williams-Bolar lived in Akron, but falsified enrollment papers in the Copley-Fairlawn School District so her two girls could attend schools for two years.

Prosecutors said the lies cost the district about $30,000. Copley-Fairlawn does not have open enrollment and out-of-district tuition is about $800 per month.

The school district spent about $6,000 to bring the case to trial. That included hiring a private investigator who followed Williams-Bolar and her children around while secretly videotaping their movements.

Superintendent Brain Poe said Copley-Fairlawn has lost hundreds of thousand of dollars because of parents illegally enrolling their children into the schools.

Poe said residency disputes are usually resolved after parents prove that they live in the district, pay tuition or remove their kids from the schools.

This marked the first time that one of their residency challenges went before a jury in criminal court. Poe said prosecuting this case was meant to send a message.

“If you’re paying taxes on a home here… those dollars need to stay home with our students,” Poe said.

One cannot honesty discuss this case without discussing the fact that Williams-Bolar is a black woman, raising black children in a city that has a large non-white population, living in a home secured through the local Housing Authority, while Copely is a very comfortably middle-class and overwhelmingly white town. Williams-Bolar is a mother who has been jailed for sending her kids to the “wrong” school district. But she’s also a black mother who has been jailed for sending her kids to a white school district.

Still, some will inevitably argue that this is not an issue of race or even class. It’s an issue of rules, of order. Someone broke the rules, and now they have to pay.

I would like to remind them firstly that who pays and how is always political.  But just as importantly, it is not arbitrary where we place borders, how we enforce borders, and who we punish for crossing them. Borders, especially modern ones, are chosen. They are artificial. We like to tell ourselves that we create borders out of necessity, to more efficiently manage communities and resources. But we also create those borders specifically to keep other people out, to control resources in a way that prevents certain populations from accessing them. There is no accident in how borders are drawn and who is being kept out and removed from resources, not along lines of race, and not along lines of class — especially not in a country were so many borders were explicitly drawn with racist intent, during times of colonization, during times of slavery, during times of Jim Crow and less “official” forms of segregation, or even during modern times of “legals” and “illegals.” It’s a little too easy to write off as coincidence that the “wrong” school district was white in a country that has a very long and modern history, both official and unofficial, of keeping all non-white but especially black students out of white schools.

As Superintendent Poe explicitly states up above, this is about “our” tax dollars, and keeping them where they belong. And anytime we start talking about “us” and “them,” we need to look at what we mean by those words, because it rarely reflects well on our intentions and prejudices. William-Bolar crossed a border that was designed to keep her out. She “stole” resources that were apparently not her or her children’s to have. (Indeed, she was also charged with grand theft, which resulted in a hung jury.)

I think it’s about time we think about what we mean by “racism” if a black mother landing in jail because she sent her kids to a better school that would not have them doesn’t count, if calling it “stealing” when she gives them access to resources these white parents get to take for granted doesn’t qualify. If we don’t understand the racism of the much higher likelihood that a black mother will have to send her child to a sub-par school that will not teach them all they need to know than a white mother, if we don’t understand the racism of punishing her for fighting back against that inherently unequal, oppressive, white supremacist system, we don’t understand the first thing about racism at all.

In fact, (though I object to his metaphorical use of the word “cripple”) I can’t say it any better than Dr. Boyce Watkins did in his blog post:

This case is a textbook example of everything that remains racially wrong with America’s educational, economic and criminal justice systems. Let’s start from the top: Had Ms. Williams-Bolar been white, she likely would never have been prosecuted for this crime in the first place (I’d love for them to show me a white woman in that area who’s gone to jail for the same crime). She also is statistically not as likely to be living in a housing project with the need to break an unjust law in order to create a better life for her daughters. Being black is also correlated with the fact that Williams-Bolar likely didn’t have the resources to hire the kinds of attorneys who could get her out of this mess (since the average black family’s wealth is roughly 1/10 that of white families). Finally, economic inequality is impactful here because that’s the reason that Williams-Bolar’s school district likely has fewer resources than the school she chose for her kids. In other words, black people have been historically robbed of our economic opportunities, leading to a two-tiered reality that we are then imprisoned for attempting to alleviate. That, my friends, is American Racism 101.

This case is a textbook example of how racial-inequality created during slavery and Jim Crow continues to cripple our nation to this day. There is no logical reason on earth why this mother of two should be dehumanized by going to jail and be left permanently marginalized from future economic and educational opportunities. Even if you believe in the laws that keep poor kids trapped in underperforming schools, the idea that this woman should be sent to jail for demanding educational access is simply ridiculous.

You should read everything he has to say on the subject.

In the end, William-Bolar’s real punishment is not the indignity and injustice of her 10 days in jail. It is the felony record that will follow her for many years to come. It will inevitably keep her from obtaining employment, from creating an economically better life for her daughters. Specifically, it will keep her from getting the teaching license she has been studying for at college — money, time, and effort all sent down the drain. A dream and opportunity taken from her because she had dreams for her daughters, wanted opportunities for them, and did the best she could in an oppressive system to see to it that they got them.

Maybe we should talk about that when we want to talk about theft, what was stolen, and from whom.

via sheresists

UPDATE: Information on how to help Kelley Williams-Bolar with her legal fees can be found here.

Berkeley, California has recently been considering beginning to provide some benefits to its trans employees for sex reassignment/affirmation surgery. It’s unclear precisely which procedures would be covered under such a plan, since all news reports merely use the outdated and offensive term “sex change” to describe what is being considered.¹ A vote on the very modest proposal has just been delayed:

The Berkeley City Council has postponed a vote on a proposal to use taxpayer money to pay for sex-change operations for city employees.

Council members on Tuesday decided to delay a final decision on the issue until Feb. 15.

The proposal calls for the city to maintain an annual $20,000 fund for gender-reassignment surgery, which can cost up to $50,000. The money would be distributed on a first-come, first-served basis.

Berkeley health insurance providers Kaiser Permanente and Health Net don’t pay for the procedure under the city’s current health plans.

To be eligible for the fund, employees would have to have lived as the opposite sex for at least one year and undergone hormone therapy. They also would have to have worked for the city at least a year.

The San Francisco Gate notes that several of the city’s 1,500 employees have apparently inquired about such benefits.

So basically, even if this proposal were passed, trans people would have to race each other to claim the woefully incomplete benefits, the inadequacy of which any cis person who is supposed to be receiving health care through their job would rightly throw a temper tantrum over. Trans folks, on the other hand, not only have to fight tooth and nail for these minimal benefits and defend themselves against national furor and smear campaigns that seek to define their health care needs as frivolous, deviant, and unnecessary, but also stand neatly in line so that one person a year might succeed at obtaining them.

Particularly as a cis woman with mountains of privilege in this debate, I’m not arguing that that the benefits would not be very real for those very few who might be lucky enough to access them. My point is simply that more is deserved. And as a general rule, if we were talking about cis folks, more would be expected. But because it’s trans rights up for debate, those same cis people are looking at the proposal as “special rights.”

One also has to wonder precisely how many cis employees must first satisfy their employer’s medical, not occupational, requirements in order to access specific kinds of care. Surely, health insurance carriers have restrictions on what they will and will not cover, and when they will and will not cover it. But one’s employer rarely designs those restrictions themselves, and rarely leaves it up to themselves to decide which medical criteria must be met. The idea that trans employees seeking such benefits must “have lived as the opposite sex for at least one year and undergone hormone therapy” is all kinds of absurd and cissexist. (For a start, how can one’s real gender be “opposite,” and how can a gender be “opposite” when there are more than two genders?) As though trans folks don’t suffer enough cis gate-keeping regarding whether or not they’re “really” trans. As though they are likely to find any cis gate-keepers who would provide such surgery to them without these restrictions being met already.

The possibility of these crumbs being thrown trans people’s way has nevertheless ignited outrage, even in Berkeley, with its reputation of being as liberal as anywhere in the U.S. gets. We’ve got biased fear-mongering headlines like “Berkeley taxpayers may pay for sex-change surgery,” Fox News surprising no one with its sensational coverage, and others filing a story about basic health care access for trans folks under “strange news.”

The general spin is an old one: SRS is “weird,” it’s unnecessary, it’s wasteful, and it’s going to result in countless cases of fraud and abuse. There’s a reason, after all, why transition-related benefits are left out of most insurance, and why the right to these benefits was not guaranteed in the latest U.S. health reform. It’s not about actual cost. It’s about what the public believes is “deserved” and “legitimate,” and who they’ll tolerate being left out in the cold. Sadly, a vast majority of the population is cis, and couldn’t care less about trans health, the very real health reasons why many trans people need medical transition care, or what happens when that need is not met.

So we’re seeing Berkeley delay its vote pending “further research.” Because clearly, research is required to determine whether or not trans people should be afforded rights slightly more equal to their cis peers.

I’m so sick of debating whether all people deserve access to health care, or just the ones who meet some arbitrary standard of social approval. Until we view health care as a fundamental human right, there’s always going to be someone who is undeserving of it — whether it be because they’re poor, or sex workers, or disabled, or trans, or in need of care related to their reproductive organ that offends somebody’s sensibilities. Until health care is a fundamental human right, there will always be someone whose life is not worth as much as “our” tax dollars.

At the same time, it’s important to remember that even framing health care as a fundamental human right still wouldn’t fully solve the problem. “Human rights” rarely end up applying to those who society still sees as less than human, and even “universal health care” rarely works out well for trans people. So health care as right or not, until trans folks are properly understood to be just as human and deserving as cis folks, the equation of “our” (super special cis-only) tax dollars being worth more than trans lives is unlikely to change.

Trigger Warning for sometimes graphic descriptions of human experimentation and medical research on non-consenting individuals

There’s a photo on my wall of a woman I’ve never met, its left corner torn and patched together with tape. She looks straight into the camera and smiles, hands on hips, dress suit neatly pressed, lips painted deep red. It’s the late 1940s and she hasn’t yet reached the age of thirty. Her light brown skin is smooth, her eyes still young and playful, oblivious to the tumor growing inside her — a tumor that would leave her five children motherless and change the future of medicine. Beneath the photo, a caption says her name is “Henrietta Lacks, Helen Lane or Helen Larson.”

No one knows who took that picture, but it’s appeared hundreds of times in magazines and science textbooks, on blogs and laboratory walls. She’s usually identified as Helen Lane, but often she has no name at all. She’s simply called HeLa, the code name given to the world’s first immortal human cells — her cells, cut from her cervix just months before she died.

Her real name is Henrietta Lacks.

– The opening words of The Immortal Life of Henrietta Lacks by Rebecca Skloot

Henrietta Lacks was a poor black woman, a tobacco farmer. She knew that something was wrong when she went to seek health care at the free “colored” ward of Johns Hopkins Hospital. She was diagnosed with a highly aggressive cervical cancer, and during her treatment — without her consent or knowledge — they cut out a piece of her. The cancer cells they cut are still alive today, are growing as I write this, are growing as you read it, are being bought, being sold, and being used for so many different kinds of research, I doubt there’s anyone who could name them all.

Henrietta Lacks died an excruciatingly painful death in 1951. And her cells have helped to develop seemingly endless medical advancements since then, and continue to develop them now. But just like Henrietta Lacks was never told that they cut out a piece of her cervix, her family was never told that here cells were still alive. The Lacks family only learned through a long series of events over 20 years later. Though those cells have made billions of dollars for various companies — both directly through the selling of HeLa to researchers, and indirectly through the selling of medicines and treatments HeLa has been integral in developing — they have not made a cent for the Lacks family. Indeed, at the time the book was written, many of Henrietta’s children and grandchildren continued to struggle financially, and several did not have health insurance to access the care that only exists because their mother and grandmother died.

The Immortal Life of Henrietta Lacks, written by Rebecca Skloot and released in 2010, is about all of this.

The Immortal Life of Henrietta Lacks is a piece of creative non-fiction, which  means that while it is entirely fact, the author heavily relies on narrative to get those facts to the reader. As a result, unlike with most non-fiction books, some of the details contained in this review could be considered spoilers by some readers.

The narrative of the book alternates between the scientific history of the HeLa cells and the personal story of the Lacks family, particularly Henrietta’s youngest daughter Deborah, who was desperate to learn more about her mother and see her get the recognition that she deserves. The book is not a “feminist book” in the sense that it does not offer a feminist or otherwise gendered analysis of the events it describes — though some relatively small race and class analysis is included. But I imagine that few who have even a passing understanding of the ways that gender, race, and class intersect and operate in U.S. society could manage to read this book non-politically.

Indeed, what was done to Henrietta Lacks and her body is as impossible to divorce from her gender as it is to divorce from her race and her class. It’s impossible to separate the violation and violence of removing a part of a woman’s body — a part of her cervix, no less — while she is unconscious, and without even bothering to ask, from the continued sense of public ownership over women’s bodies and reproductive lives, black women’s especially. It’s impossible to divorce that violation from the ongoing history of sexual violence against women, and sexual violence against black women by white men in positions of authority specifically. It is as impossible to divorce her treatment from her gender in the same way that it is impossible to divorce it from the history of non-consensual scientific experimentation on African Americans or the history of slavery or the context of segregated hospital wards. It is as impossible to render her gender irrelevant just as it is impossible to render irrelevant the notion that doctors felt poor patients owed the “donation” of their bodies for scientific research as a form of payment for their care.

The point is not that they would not have stolen from Henrietta Lacks’ body if she had been a man, or if she had been white. The book presents evidence, in fact, that they likely would have. The point is that context matters, especially when at stake are not only individual senses of trust and safety, but lives. Violations don’t occur in a vacuum. This violation was committed against the backdrop of racism, classism, and misogyny, as did the ongoing violations committed against her family.

At no point is this made more clear than through the story of Elsie. Elsie was Henrietta’s second child and oldest daughter. Elsie had both cognitive and physical disabilities, and required a full-time caretaker. Henrietta was the only one available to act as her caretaker, but she had four other children, including two babies — so after years of resisting, she did what doctors told her was best and sent her to the Hospital for the Negro Insane. She visited Elsie every week until she got sick, and then no one visited her. Elsie died a few years after Henrietta.

Elsie’s story is not told within the context of the devastation that Henrietta felt at relinquishing her daughter, but rather what was done to Elsie after she was committed. It is eventually revealed that she not only lived in horrific conditions marked by abuse, and died a horrific death, but also that she was the subject of abhorrent, non-consensual human experimentation because of her disabilities and institutionalization. They drained the fluid surrounding her brain and pumped air into her skull. They inserted metal probes into her brain. She would have suffered extraordinarily. These things were done to her because she was black and disabled. Because no one ever thought that she or her family might have a right to say no. Because no one cared.

What was done to Elsie matters simply because it does. It matters because she matters. But it matters within the context of the Lacks story for the way it illuminates the climate of abuse and brutality that the violations against Henrietta Lacks were committed. These violations were far from isolated. And they were also far from extreme by the standards of the day. What was done to Henrietta and what was done to Elsie existed at two ends of a spectrum, but they were both a part of the same racist, dehumanizing system.

The cruel irony is that Henrietta’s cells, too, have been used to do highly unethical testing on unknowing patients, largely those with disabilities. Though paling in comparison to the literal torture committed against Elsie, HeLa cells were injected into unknowing, non-consenting individuals — mostly those with disabilities or serious illnesses — in order to see if they would develop the same cancer that Henrietta had. Henrietta was not just violated at the hands of this system; her violation was also used as a means to further its abuses.

Without being pedantic or even particularly explicit, Skloot beautifully weaves together these two “separate” historical stories. Overwhelmingly, the point of telling the stories of the Lacks family’s many misfortunes is not to show what evils HeLa cells brought on their lives. Though the Lackses did experience trauma as a result of their connection to the cells, it is not the direct cause of most of their problems. Rather, their story serves to reveal that a great deal of their problems did stem from Henrietta Lacks’ death — and to remind us that it was only because a woman got extremely sick and died that so many of us have had access to treatments and vaccinations that have kept us alive. It’s to remind us that while Henrietta did not donate her cells, they were stolen from her, she and her family did make an unchosen sacrifice. It’s to remind us that researchers didn’t just take a part of her — they took the part that killed her. And she, and her family, are real people. Real people whose lives matter, too.

But they have been treated repeatedly as if their lives mean nothing. As if Henrietta’s life was not worth anything. As though the horrors those cells have imposed on their lives do not matter in the face of the medical advancements. As if their mother and grandmother did not have a right to her own body, and they do not, as her descendants, have a right to it on her behalf. As though their bodies mean nothing, too — and they do not, with their frequent lack of health insurance, have the right to access the care that only exists because their mother or grandmother died.

It’s long past time that Henrietta Lack’s story was told, that her family’s story was told. For the fact that it accomplishes that vital justice, and for the eloquence and sincerity with which Skloot tells the story not only of Lacks by the history of ethics in biomedical research, I couldn’t recommend The Immortal Life of Henrietta Lacks more strongly. This is a story that needed to be told, and that needs to be read.

Sadly, it is also long past time where things could ever truly be made right. Years cannot be undone, dead family members cannot be brought back to life. But the remaining Lackses do still deserve that which has always been rightfully theirs, as well as our gratitude, though it seems that those who most owe it to them are not going to be the ones to provide it.

As promised to Deborah Lacks while she assisted in writing the book, Rebecca Skloot has set up the Henrietta Lacks Foundation, which provides funding for education and health care to the descendants of Henrietta Lacks. Again, while billions have ultimately been made from Henrietta Lacks’ stolen cells, her family has never seen a single cent from their use, and family members are often without health insurance, and without access to the funds needed to access higher education. Anyone can make a donation to the Henrietta Lacks Foundation by clicking through to their website.

A new study purports to show a disturbing discrepancy between the number of teens who say they’ve “had sex” with those who test positive for STDs. Of those who supposedly said they’d been abstinent, 10% tested positive for at least one of the three common STDs (chlamydia, gonorrhea, and trichomoniasis). As such, researchers and journalists have assumed that at least 10% of those who said they hadn’t had sex must have been lying to their doctors about their sexual histories.

When I first saw the headlines — “Some young adults with STDs say they’ve never had sex”, “‘Abstinent’ teens test positive for STDs” — I assumed that a significant portion of the discrepancy could likely be accounted for by a failure to adequately explain to the teens what “sex” means. The fact is that in dominant culture, “sex” very unfortunately still means “penis-in-vagina intercourse” to the vast majority of people. Ask a lot of teens if they’ve “had sex” and they very well might say no and believe they are telling the absolute truth — even though they may have engaged in all kinds of non-intercourse sexual activities  such as oral sex, hand to genital contact, non-penetrative genital rubbing, etc. And, of course, these kinds of sex all present the potential for STD transmission, to varying degrees.

But my assumption was wrong. The researchers didn’t fail to adequately define “sex” for the study participants — they explicitly excluded all non-intercourse activities themselves in their questioning, by asking only whether each person had engaged in sexual intercourse in the past 12 months.

So let’s talk, instead, about the problems with the study. Frankly, I’m appalled that it’s treated by researchers as though it can teach us anything useful at all. The wording of the question erases all sexual activity that takes place outside of cis heterosexual sexual pairings, contributing yet again to the cultural notion that no other sexual pairings exist, let alone matter. It also erases a good deal of sex that takes place between cis men and women, too — and if what went on during my teenage years are any indication, an even greater deal of what goes on between teenagers who are in sexual relationships but not ready for or interested in intercourse.

So we’ve ended up with some extremely inconclusive data. Even the researchers themselves acknowledge that some of the STDs among those who did not report engaging in intercourse could have been transmitted more than 12 months ago or through non-intercourse sexual activities. Though they try to downplay this likelihood, the fact is that you don’t know what you don’t take the time to ask. Posing better questions in the first place would eliminate a significant amount of guesswork.

But the researchers seem to have nonetheless drawn their conclusions:

Study findings indicate that “sole reliance on young adults’ self-reported penile/vaginal sexual activity as a marker for STD acquisition risk may be imprecise and further, could be problematic,” the researchers write.

They argue that future research should attempt to find ways to reduce “discrepant” reports by young people about their sexual activity.

The researchers note that they did not collect information about anal sex among men and that some cases of chlamydia may persist 12 months after sexual intercourse. And study participants only indicated whether they’d had sex had in the past 12 months.

“Given the length of the reporting interval, the previous 12 months, young adults’ retrospective recall could be inaccurate,” the researchers write. However, they add that “volitional underreporting” could explain discrepancies between self-reports and facts.

The findings suggest that doctors should do more than just ask young people about their sexual activity.

“Importantly, our findings reveal that if pediatricians and adolescent medicine physicians do not test all young people, there are likely a substantial number of missed cases of STDs that will go undiagnosed, untreated, and spread to future sex partners,” the researchers write.

Now, it’s not that I’m opposed to more STD testing. As long as informed consent is involved, this strikes me as a good idea. Once privacy and financial concerns are accounted for, consensual STD tests that turn up negative cause little harm. Not conducting STD tests that would have come back positive, on the other hand, causes a great deal. There certainly is a “better safe than sorry” argument to be made.

What unnerves me is the casual glossing over of the inadequacy of the questions asked — and the complete absence of a recommendation that doctors should ask better ones. I say that better than assuming young people to all be a bunch of liars, doctors should work harder to establish meaningful communication with patients and, importantly, to interact with them in a non-judgmental way. A way that doesn’t assume them to be straight, a way that doesn’t assume there’s only one kind of sex, a way that doesn’t suggest imminent judgment if a female patient says she has had sex, a way that doesn’t suggest an assumption that a non-white patient or low-income patient must have had sex. A way, in other words, that treats patients compassionately and humanely.

It’s also important to get to the root of the problem that’s even more insidious than the extremely common and even cultivated feeling of fear and intimidation towards doctors — the social fear of sexuality, and the dominant attitude that sexual activity is something to hide.

To the extent that some young people undoubtedly are lying about their sexual histories to their doctors, surprise is both a naive and irresponsible reaction. Most of us growing up in a sexphobic culture absorb the message through one means or another that sex is something to be punished — if you’re a woman, if you’re queer, if you’re trans, if you’re not married, if you’re non-white, if you’re poor, if you’re disabled, if you’re kinky. Pregnancy and STDs are often misconstrued as “punishments” for having kinds of sex that are not socially approved. And very real punishments are often enacted for certain sexual behaviors — whether they be slut-shaming, homophobic verbal and physical assaults, other forms of social ostracizing, or being cut off from financial support.

Young people are perhaps the most at risk for punishment for sexual behavior. Adolescent sexuality is frequently seen as flat-out wrong, and it’s still considered entirely appropriate for parents to penalize teens for consensual behavior they’ve engaged in with their own bodies. The law has the right to punish them, too — not all states allow minors confidential access to contraception, and most states require that parents be notified prior to an abortion. Coupled with huge gaps in sex education, there’s a lot of fear surrounding the acknowledgment of sexual activity for young people, and many legitimate reasons for it.

In other words, this isn’t just a problem of doctors not being patient, or compassionate, or kind, or understanding, or unbiased enough — though those are very real problems for many people. It’s a social problem regarding how we, as the dominant culture, treat sexuality. It’s something that can’t be cured with a few “sensitivity” trainings, with a book, with a small group of people just giving it a little practice.

But it is something to consider. What if those of us who were raised either explicitly or implicitly to believe that sex is dirty, secretive, and unspeakable hadn’t been? What if we didn’t see sex everywhere, but honest dialogue about it almost nowhere? What if the sex we saw portrayed was genuinely varied both in practice and participants? What if some entirely consensual sexual practices weren’t routinely portrayed as “weird” and “deviant” while non-consensual ones were portrayed as “normal” and “how it works”? What if sex was treated as healthy, for those who want to have it, when they want to have it? What if desired, consensual sex was not treated as something to be hidden, something that was frowned upon or disapproved, something that might result in shame — and not desiring or having sex was treated the same way? What if having an STD or unplanned pregnancy did not have a stigma attached to it? What if there was no confusion about what people meant when they talked about sex, because questions could be asked openly and without embarrassment? What if knowledge of your sexual orientation or activity wasn’t tied to the threat of not having a place to live, a caretaker to help you live independently, or money to survive? What if knowledge of your sexual activities wasn’t likely to be used as a weapon against you because of your race, class, disability, gender identity, or sexual orientation?

I imagine that there would be fewer teens — and adults, for that matter — lying to their doctors about their sexual activities. Because the reasons why we do so would be gone. And they’re not issues that doctors alone can fix, but ones that are on all of us.

One final point: while I imagine this only accounts for a fairly small portion of the discrepancy, it’s important to note that even with better, more inclusive questions being asked of patients, some who say they have not had sex yet still test positive for STDs will undoubtedly be telling the truth. It’s called sexual assault. Young people are particularly at risk for sexual violence, and this fact is almost universally erased whenever the topic of pregnancy and STD risk comes up. Most STDs are passed through consensual sex. But not all. There are very good reasons to ask patients about histories of sexual violence, including reproductive coercion, during medical visits. Assessing a patient’s risk for sexually transmitted diseases is just one of them.

Trigger Warning for discussions of sexual violence within a medical context.

Earlier this year, I wrote about part of a Chicago Tribune series that exposed how Illinois doctors can pretty easily sexually assault patients and get away with it with few to no negative consequences for their violations, frequently even being allowed to keep their licenses to practice medicine. The topic has come up again, as the series has thankfully inspired legislators to finally take some action. As a recap, here’s what the Tribune found:

•Under Illinois law, a sex-crime conviction does not trigger an automatic or permanent revocation of a doctor’s license. In some cases, such doctors lost their license for several years. One doctor convicted of sexual abuse of a patient was never disciplined by state regulators in any way.

•Because sex crimes can be difficult to prosecute, doctors are sometimes convicted of misdemeanor battery. Regulators place these doctors, as well as physicians found guilty of sexual misconduct without a criminal conviction, on an overburdened professional probation program that does little to prevent them from reoffending.

•Law enforcement officials and state regulators are not required to inform each other of patient complaints against doctors. It often takes multiple allegations before they take action.

•This year, Illinois stopped providing the public with detailed histories of the state’s doctors, including whether the doctor was convicted of a crime, fired by a hospital or forced to make a medical malpractice payment within the last five years. The state’s medical lobby has fiercely opposed these profiles.

Why, exactly, a sex crime conviction does not trigger an automatic revocation of one’s medial license, let alone a permanent one, is not at all clear. Nor is it clear why Illinois decided to put the medical lobby’s personal preferences above patient safety — though I do have exactly one educated guess, and it starts with “m” and ends with “oney.” Clearly, real reform is going to take the political will to stand up to check-waving lobbyists in favor of relatively poor health care consumers, and sadly such will is far from a given.

Here’s what state legislators have come up with so far:

State legislators, Gov. Pat Quinn and Attorney General Lisa Madigan agree that change is necessary, but they are not yet certain what shape reforms should take.

State Rep. Mary Flowers, D-Chicago, with the support of House Speaker Michael Madigan, plans to call a bill on Tuesday that would resurrect public access to the physician profiles.

State Sen. Kirk Dillard, R-Hinsdale, said he plans to strengthen legislation that he recently introduced. It would make health care workers whose licenses are revoked because of sex-crime convictions unable to reapply for the license for at least five years, but it does not require that the license be revoked in the first place.

State Rep. Jack Franks, D-Marengo, has introduced legislation that would mandate revocation in the cases of doctors convicted of sexual assault or battery of a patient, and not just those involving felonies.

Lisa Madigan’s office, meanwhile, is crafting legislation that would require law enforcement officials and state regulators to share patient complaints against doctors, while contemplating other possible changes.

Sometimes I feel like I’m living in the Twilight Zone.

It’s not that the ideas presented above are necessarily bad ones. It’s that for the most part, they’re glaringly and woefully inadequate. And it’s astonishing that a combination of pitifully obvious measures that should have been passed years ago and miserably half-assed proposals are what most who have even bothered to try managed to dream up.

Yes, of course state regulators and law enforcement should have to share complaints against doctors. Seeing as how a lack of communication here has allowed perpetrators to go free and patterns to go undetected, this should be a given. But measures should certainly not stop there. And the plan to resurrect public access to physician profiles is a good one, but here’s the thing — patients shouldn’t need to have the education to know they should research whether or not their doctors have been known to previously rape someone, let alone the resources to then do so. They just shouldn’t. No one should have to live in fear that maybe their doctor was once proven to have sexually assaulted a patient; or be aware that their doctor might actually be a rapist, because the law allows rapists to continue being doctors; or have to take the personal initiative to try to protect themselves from predatory doctors, all before they schedule their routine pap smear. Resources are good things, but not when research is left as patients’ only line of defense. Placing sole responsibility in the hands of patients, quite possibly setting up a new “maybe you should have researched your doctor first” form of victim-blaming, is just plain wrong.

But I think that State Sen. Dillard’s proposal, which technically goes further than either of the two listed above, angers me the most. The increased veneer of accountability for perpetrators backed up with actually nothing of the sort sends me into an incoherent rage. While ostensibly increasing the restrictions on medical licenses for sexual offenders, it doesn’t require that the sex offenders automatically have their licenses revoked. Further, not allowing them to reapply for their license until 5 years later is treated as some kind of progress. Is there something magical about 5 years? Something which guarantees that all the desire to violate, humiliate, and assault vulnerable persons has left their psyche? Because to me, it sounds like a completely arbitrary and really, really patronizing number that assumes rapists have the right to continue having access to potential victims while making large salaries and having great deals of social clout to boot.

Here are the facts: no one has the right to practice medicine. No one. And while regulations about who can and cannot access a privilege not generally guaranteed to the public frequently are oppressive, regulations preventing known sexual abusers from having access to the bodies of individuals in private and highly vulnerable situations are not among them.

Of course we wish to reform violent offenders. But one is not guaranteed to have been reformed simply because an arbitrary number of years has passed. Further, when we’re talking about a person in a highly sensitive and authoritative position of physician having committed sexual violence, it seems best for the “one strike and you’re out” rule to apply. The fact is, we restrict actual fundamental rights with far less reason in this country every single day. Take note of the fact that in all but two states, felons are disenfranchised, very often even after they’ve served their time, and even though many felons were convicted on mere drug or property crimes. I hope I don’t have to explain why it is absurd that in the U.S., many people who were caught with too many drugs can’t vote, while some people who were caught raping someone get to keep being doctors. We’re fine violating the constitutional rights of marginalized people, but queasy about revoking the special benefits that generally privileged folks get to enjoy.

That makes State Rep. Franks’ proposal by far the best — especially since it encompasses misdemeanor convictions in addition to felonies — though the Tribune does not note whether or doctors would be able to reapply for their licenses under his proposal after a set date. If they would not, it would certainly be a huge improvement on the status quo, and probably close to the best that can be done at the legislative level.

But I’m incredibly wary of any system that bases revocation of medical licenses on criminal convictions. The fact is that convictions for sexual assault are rather rare in the U.S. criminal justice system. Most victims don’t feel safe reporting their assaults to police, for a wide variety of reasons. Many highly credible cases that are reported are not pursued. Rapists are regularly ruled not guilty by biased juries wallowing in rape apologism and victim-blaming. And which rapists are convicted and which are not tends to fall heavily along lines of race, class, sexual orientation, dis/ability, gender identity, and more, for both the victims and perpetrators. The more marginalized a victim’s identity, the less likely sie is to see hir rapist convicted. The more privileged a perpetrator is, the less likely sie is to ever see repercussions for hir crimes.

We need to stop relying so heavily on our irreparably broken legal system to met out justice. Because right now, it’s barely even doing so at all, and is actually perpetuating a great deal more of injustice. We need to look into alternatives outside the criminal justice system. And to me, one available here seems pretty obvious. Medical boards exist for a reason — to regulate, investigate, punish, and attempt to prevent all types of misconduct. I see no reason, other than lack of political will, why they cannot and should not develop their  own independent systems — not tied to money, or inside politics of who knows and who likes who, or the criminal justice system — specifically for encouraging and taking reports of sexual assault, investigating them, and determining guilt. The standard of evidence can and should be lower than that for criminal trials, and based on a “preponderance of evidence” model from civil courts (rather than a “beyond a reasonable doubt” criminal model). And all found to have committed assault under such a system should have their licenses revoked and not be allowed to reapply.

Would such a system be perfect? No. Do I see lots of ways for it to easily devolve into a mere shell more interested in “saving face” than holding perpetrators accountable? Easily. And that’s why it needs to be designed properly from the start, and from scratch rather than attempting to reform similar systems already in place. Would it be subject to the same kyriarchal biases as the criminal justice system? Quite likely! (And see point two.) But since the current system already has these problems and a whole lot more, I don’t see that as any reason not to, at the very least, start exerting pressure on medical boards to try. What we’re doing isn’t working. And people’s health and very safety is on the line.

The question, of course, is whether we care more about that or the right of abusive doctors to keep raping and otherwise violating patients with impunity. I sadly think I know the answer, but there’s only one way to prove me wrong.