Tag: gender

Blog Posts (18)

July 18, 2016

Rape as a public health issue

Some people may be surprised that I am discussing rape on a bioethics blog because they do not think that sexual violence is a bioethics issue. However, rape is a public health matter that raises serious ethical concerns, especially regarding justice and equality. The goal of public health is to protect and improve the lives of the public. Rape harms many people especially women: 1 out of 6 women and 1 out of 33 men in the United States will experience a rape or attempted rape (Esposito 2006).

The act of rape can cause various immediate health concerns such as general body trauma (e.g. bruises, lacerations, broken bones, etc.), STI exposure, and unintentional pregnancy. Rape also has long-term health consequences for survivors both psychologically and physiologically. Rape survivors frequently experience depression, anxiety, PTSD, and negative sexuality issues. Furthermore, sexual violence has been connected to health problems for survivors across almost all body systems (e.g. gastrointestinal, cardiopulmonary, etc.) (Wasco 2003).

Rape is not only harmful to its victims, but rape culture has a toxic effect on women as a group. Rape culture perpetuates an oppressive patriarchal system in which women are sexually objectified and devalued. Furthermore, rape culture leads women to live in constant fear about their physical safety because they are worried that they will be victims of sexual assault. Feelings of objectification and devaluation as well as anxiety regarding one’s safety are clearly not good for women’s health.

Despite the deleterious effects rape has on its victims, women as a group, public health, and society at large, as we have seen with the Brock Turner case, as well as other cases, unfortunately our legal system frequently does not treat rape as a serious crime. In a recent publication, “Rape as a Hate Crime: An Analysis of New York Law,” I argue that the punishment for rape should carry more serious consequences. Specifically, I claim that in most cases rape should be considered a hate crime since the rapist chooses the victim based on gender, gender identity, and/or sexual orientation. Recognizing rape as a hate crime would not only qualify it for sentencing enhancements, but it would also acknowledge that rape reinforces the patriarchal and heteronormative hegemony.

 

 

 

References

 

Esposito, N. (2006). Women with a history of sexual assault. Health care visits can be reminders of a sexual assault. Am J Nurs, 106(3), 69-71, 73.

 

Wasco, S. M. (2003). Conceptualizing the harm done by rape: applications of trauma theory to experiences of sexual assault. Trauma Violence Abuse, 4(4), 309-322.

April 28, 2016

Expanding The Moral Community: Why is it so hard?

Much of American history can be described as the struggle to expand the moral community in which an increasing number of human beings are seen as having basic rights under the constitution. We forget sometimes that though the inclusion of all people was perhaps implied in our early documents, as in “We hold these truths to be self-evident, that all men are created equal…” from the Declaration of Independence, it has taken historical time and struggle to come closer to realizing that ideal. This struggle has been the quest for recognition of more and more individuals not assumed initially to have the right to vote and exercise control over their lives, which included African Americans, women, minorities, and more recently the LGBT community. The growing recognition of more and more individuals as being full fledged citizens has been a slow, often painful, birthing process of freedom, in the sense of unleashing human potential and possibilities, within the democratic process.

 

The recent uproar over the Anti-LGBT law passed in North Carolina is a reminder of how difficult it is for many states and communities to accept and accommodate historically marginalized people into the mainstream of society. This law was a quick reaction by the right wing North Carolina legislature and governor to an ordinance passed in Charlotte, similar to what other cities around the country are doing, allowing transgender people to use restrooms according to their gender identity. Perhaps this law also should be seen as a reaction to the Supreme Court ruling in 2015 legalizing same-sex marriage, which has been propelling society toward greater openness and acceptance of LGBT life styles, integrating them into the mainstream. Many who favor the Anti-LGBT law claim that individuals born as male, but are now identifying as female, could pose a risk to women and girls in public bathrooms, though there seems to be no substantial evidence whatsoever of such a risk. My sense is that the individuals who support this law in fact are using risk as a smokescreen in attempting to preserve what they perceive as waning values and norms in society: In the name of conservatism they hang on to an exclusionary vision of society that no longer fits the conditions of expanding freedom and opportunity.

 

So what some see as waning values and norms, others see as moral progress toward more robust democratic ideals and values. This inherent, historical struggle of opposing social and political forces has resulted with unexpected rapidity in the social and legal acceptance of gays and lesbians in the past 20 years in the United States. Most young people today especially those living in metropolitan areas, like Charlotte, where cultural diversity is a daily reality, readily accept that people naturally have different sexual orientations and gender identities, which people should be free to express in their lives. This liberal openness to diversity likely stems from the fact that they live in the midst of, and have normal interactions and friendships with, people of diverse sexual orientations and gender identities, which prompts them to look upon them as neighbors and as normal people. On the other hand, my guess is that many of the advocates of the Anti-LGBT Bill in North Carolina have little or no contact (of which they are aware) and no or limited relationships with LGBT individuals. Also, part of the resistance to greater inclusion of the LGBT community could be stem from the anxiety of having to recognize one’s own uncomfortable feelings and inclinations about sexuality and gender.

 

An additional factor to explain the reluctance of many self-identified conservatives to accept alternative sexual and gender orientations may be related to religion. Particularly, in the “bible belt” regions, regardless of whether or not they are followed by church leaders and members, clear notions of basic moral norms of right and wrong are assumed. Sadly, religious morality has been historically integrated with and used to justify a range of regional cultural values and norms—even heinous ones such as the use of Christianity to justify the institution of slavery. But in fairness even many Christians outside the bible belt follow Catholic natural law theory based on certain features about human nature from which basic norms are predicated about what is “normal” as well as “right” and “wrong” in a content rich, objective sense. In short, the point is if one believes that members of the LGBT community are engaging in a personal life style that is assumed to be inherently immoral, a barrier to inclusion is created.

 

So we in America today are in the midst of a culture war between conservative communities in rural and smaller towns on the one side espousing religious assumptions about human nature (which affects how they perceive risks) and liberals celebrated diversity in more progressive, metropolitan areas on the other. Advocates on either side of this divide bring to bear ideas and theories in an effort to convince others of their position. However, my sense is that articulating arguments to defend the root moral assumptions of either side is unlikely to change the minds of individuals on the other side. The result seems to be communities of individuals living in parallel universes with alternate moral vocabularies who “talk at” each other. Though I am for a liberal, moral vocabulary to account for moral progress within the democratic process, the real change that many of us liberals seek really is at the emotional, and even spiritual, level relating to how human beings are able to show empathy and respect for their fellow human beings in their communities.

 

We know human identity is based largely on social identity within a particular group or groups related to broad social categories such as religion, race, ethnicity, social class, etc. and to more specific ones such as professions, sports teams, political parties, etc. One of the inherent features of social identity is that individuals have a sense of self-identity by virtue of their group affiliations, which is also defined in terms of groups with which they are not affiliated and to which they stand in opposition. When group identities become rigid, to the point of engendering animus toward other groups, barriers are created which can marginalize the rights of individuals in those groups. But through exposure to, and openness to personal relationships with, individuals outside one’s own group, group identity becomes more flexible and open to change—this is an inner change of heart and disposition toward others.

 

Perhaps many of those who self-identify as conservatives in North Carolina who favor the Anti-LGBT law, and who also are predominantly Christian, should remember the ministry of the central character of their faith tradition. The thrust of Jesus’ ministry as defined by scholars like John Dominic Crossan is one of radical inclusion and hospitality. Jesus spent his time interacting with, eating with, and drinking wine with those on the margins of society who were outcasts and viewed as unclean and dangerous according the prevailing hygiene laws. His message to these people was that they too can be included in the moral community and be loved like all others. This is a robust message of compassion and love.

 

Ultimately, struggle for expanding inclusion can only succeed when opponents of bills like the Anti-LGBT Bill are able to show members of the LGBT community the kind of compassion and love Jesus showed to those on the margins of society in his day. The struggle of inclusion really is the struggle to expand what one thinks of as the moral community, or more simply, the neighborhood.

 

 

 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

April 26, 2016

Transnational Reproduction: Race, Kinship and Commercial Surrogacy in India

Wednesday, April 27, 12:15 – 1:30 p.m. | Walsh Library Special Collections room Join us for a lunchtime lecture and discussion led by Daisy Deomampo, Ph.D. (assistant professor of anthropology, Fordham). Her research focuses on the intersection between technology, gender, health … Continue reading
March 4, 2016

Ethics & Society Newsfeed: March 4, 2016

NIH vowed to move its research chimps from labs, but only 7 got safe haven in 2015 Nearly three years after the National Institutes of Health announced that hundreds of chimpanzees held for invasive medical experiments would be retired to a … Continue reading
February 10, 2016

Penis Transplants Coming to America

The New York Times recently reported that physicians will soon undertake the first penis transplants in the U.S. The goal of this procedure is to restore everyday functionality as well as sexual functioning for men with genitourinary injuries, which are injuries involving loss of part of all of the penis and/or testicles. The donated penis will come from a deceased donor, with that donor’s permission. Penis transplants have only taken place in China in 2006, where the procedure failed due to the recipient psychologically rejecting the transplant, and in South Africa in 2014, where the procedure was successful. 

For the time being, this procedure will be limited in the U.S. to men who lost their penis in military service. In the last 15 years, over 1300 men have suffered genitourinary injuries in Afghanistan or Iraq, mainly due to homemade bombs. Almost all of these men are under 35 years old.

One objection to penis transplantation is that it is not life-saving. While it is true that penis transplants are not life-saving, much of modern medicine focuses on improving quality of life (e.g. glasses for poor vision, over the counter medication for the common cold, physical therapy for back pain, assisted reproductive technologies for infertility, etc.). While a genitourinary injury may not be visible to others, the effect on the individual can be devastating. For many men, the penis is a symbol of his masculinity and not having “normal” genitals can impair his gendered and sexual identity. As I have discussed in my published research,

“the male genitals are generally central to a man’s coherent sexual identity, and are associated with stereotypical masculine traits like “strength” and “courage.” Because of the personal, as well as social, significance of the male genitals, having “misfunctioning” (e.g. impotent, prematurely ejaculating, infertile) genitals or genitals that look “abnormal” (e.g. small penis, missing a testicle) can diminish men’s sense of masculinity.”

Given the significance of the male genitals to men, it is not surprising that many male patients find a genitourinary injury to be the worst type of injury possible. According to Scott E. Skiles, the polytrauma social work supervisor at the Veterans Affairs Palo Alto Health Care System who is quoted in the New York Times article on penis transplants, “Our young male patients would rather lose both legs and an arm than have a urogenital injury.”

The psychological suffering caused by genitourinary injuries should not be underestimated. The objection that a penis transplant is merely “elective” and not medically necessary overlooks the profound effect a genitourinary injury can have on a man’s mental health. While there are still concerns about penis transplants, namely the fact that they are still experimental, they should not be equated with other types of surgeries that purely or mostly cosmetic.   

 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

 

September 14, 2015

Is Sex Selection Ethical?

<p>In some countries where there is a strong preference for sons due to cultural and religious reasons, women sometimes choose to have an abortion after learning the sex of the fetus they carry is female, which is often referred to as sex selection abortion. For example, <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166246/">sex selection abortion</a> is common in India and has increased significantly in the couple of last decades, especially for pregnancies following a firstborn daughter. The prevalence of sex selection abortion is also common in China, often referred to as the “<a href="http://jhr.uwpress.org/content/45/1/87.short">missing girls of China</a>” phenomenon, and is due to a similar cultural preference for sons as well as the One Child Policy.</p> <p>Given the strong pressure women are under to have sons, is ethical for them to have sex selection abortions? Some point out that it may not be women’s authentic choice that is leading them to abort female fetuses but rather familial pressure from their husband and other family members as well as broader social pressure. In these situations, paternalistic approaches may be more justifiable in order to protect women from oppressive social forces that may coerce them into having sex selection abortion. From a justice perspective, outlawing sex selection abortion sends the message that sex discrimination is wrong, seeks to protect female fetuses, and attempts to ensure a balanced birth ratio between females and males.</p> <p><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.04px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.04px;">Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>
August 28, 2015

Marketing Trumps Science, or How the Pink Pill Does Not Even the Score

<p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">This month’s blog is going to be a bit of a rant. I don’t generally consider myself a rant-y person, but some of the commentary surrounding the recent </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm458734.htm">FDA approval</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"> of the sexual desire disorder drug Addyi has proven too much for my delicate constitution.</span></p> <p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">First, what I am NOT doing: I am NOT denying the existence of hypoactive sexual desire disorder (HSDD), or that for women who are so afflicted it can cause serious distress or otherwise negative consequences. I am NOT challenging the notion that HSDD is a medical problem that warrants seeking a medical treatment or medical solution. I am NOT arguing against pharmaceuticals in general, or here specifically, as a potentially viable medical treatment for HSDD. I am NOT saying all pharmaceuticals should have absolutely no risks or side effects, or should be required to produce overly substantial benefits for it to be appropriate for them to be FDA-approved and released to the market. I am NOT calling into question the claims that there are very real sex and gender disparities in medicine, human medicalization, and medical treatment. And I am NOT disputing the value of empowering women with greater control over their own bodies and their own healthcare.</span></p> <p><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;">Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>
June 29, 2015

iPhone App Will Track Sexual Activity and Reproduction

<div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Apple recently announced that they will update their health app, HealthKit, to include reproductive health. Many were critical of the original app because although it can track a wide range of health indicators, such as BMI, sleep, sodium intake, number of falls, etc., it neglected reproductive health. Specifically, <a href="http://fusion.net/story/100781/apple-ios-update-new-version-of-healthkit-still-doesnt-track-periods/">it is problematic</a> that the app includes some obscure health indicators, like selenium intake, but not menstrual cycle, which affects half of the population. While there are other apps that are specifically geared toward women's reproductive health, it is troubling that an iPhone app that comes standard with the phone would exclude something so central to women's health as menstruation. Some believe that the omission of reproductive health from HealthKit is due to the fact that the tech world, including Apple, is dominated by men.  </div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><br /></div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">The new the updated app is a huge improvement because it includes a variety of reproductive health indicators like menstruation, basal body temperature, and spotting. The broad range of reproductive health indicators helps women keep track of their reproductive health in general and specifically for women looking to prevent pregnancy and for women looking to achieve pregnancy. This is an important addition because too often reproductive health is overlooked or not considered part of "real" healthcare. The addition of the reproductive health category in HealthKit technology not only acknowledges the reproductive health issues specific to many women, but also normalizes them.</div> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
February 17, 2015

Men's reproductive health: Neglected in policy and practice

<div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">In recognizing the health-related and financial benefits of preventive reproductive health services, the Affordable Care Act (ACA) has included them (namely contraception and preconception care) as part of standard care and without co-payment. While the inclusion of women’s reproductive health care in the ACA is a milestone for women’s health, children’s health, and reproductive health overall, it is troubling that the ACA does not seem to make any mention of men’s reproductive health</div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><br /></div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Men's reproductive health is not only missing from policy, also from everyday practice. Whereas women know to see a gynecologist for their reproductive health and can easily do, men are often unsure of where to turn for the reproductive health needs. Most men have never heard of the field of andrology, which is devoted to men's reproductive health, and this field is so small and fragmented that it may be difficult for a man to find a nearby andrologist. Some men seek out urologists for their reproductive health, but many urologists are not trained in all areas of men's reproductive health. Men may also talk to their primary care physician about their reproductive health needs, but many of these physicians are not very familiar with men's reproductive health since it is barely covered in medical school. Family planning centers tend to focus on treating women and some family planning providers have even been known to be hostile toward men. The lack of healthcare providers trained to treat in men’s sexual and reproductive health contributed to American Board of Obstetrics and Gynecology recent statement that condoned OBGYNs treating certain areas of men’s sexual and reproductive health.</div> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"> </span></p>
October 22, 2014

The Ethics of Sperm Freezing for Teenage Boys

<p class="MsoNormal" style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">A few weeks ago, I attended the </span><a style="line-height: 19.0400009155273px;" href="http://oncofertility.northwestern.edu/2014-Conference">annual Oncofertility Consortium conference</a><span style="line-height: 19.0400009155273px;"> where Dr. Angel Petropanagos and I presented our poster “Teen Boys and Fertility Preservation: An Ethical Analysis.”</span><span style="line-height: 19.0400009155273px;">  </span><span style="line-height: 19.0400009155273px;">The vast majority of discussions about fertility preservation (FP), particularly FP for “social” (aka nonmedical) reasons, are focused on women in part because FP for women raises more ethical issues.</span><span style="line-height: 19.0400009155273px;">  </span><span style="line-height: 19.0400009155273px;">For instance, egg freezing carries more health risks and is generally less effective than sperm freezing. Furthermore, whereas sperm freezing has been an established method of FP for decades, it was only two years ago that the American Society for Reproductive Medicine lifted the experimental label from egg freezing.</span></p> <p class="MsoNormal" style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">Yet, even established technologies can raise ethical concerns when used in vulnerable groups, such as children. Our research project examines the ethical issues FP raises when used by teenage boys.</span><span style="line-height: 19.0400009155273px;">  </span><span style="line-height: 19.0400009155273px;">In order to undergo sperm freezing, males must produce a sperm sample and this is usually done through masturbation. However, discussions about masturbation can be embarrassing and difficult for adolescent males (as well as for healthcare providers), particularly if they have never masturbated or never masturbated and achieved an ejaculation. Some parents and healthcare providers place a high value on preserving patients’ future option of genetic reproduction, but FP discussions with teen males can be especially challenging due to the sensitive and private nature of sexuality and reproduction. </span></p> <p class="MsoNormal" style="line-height: 19.0400009155273px;"><strong style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>

View More Blog Entries

Published Articles (1)

American Journal of Bioethics: Volume 6 Issue 2 - Mar 2006

Bioethics' Gender

News (2)

July 2, 2012 3:32 pm

The IOC's superwoman complex: how flawed sex-testing discriminates (The Guardian)

This is not science. It is a gender witchhunt, and it is foul play. This is why experts in sports, gender, and bioethics – and those battling discrimination against female and LGBT athletes – have been mobilizing against this policy ever since its basic shape was announced last year.  What’s really driving these policies is suspicion of women perceived as gender “deviant”. We see this all too often in women’s sports when women athletes monitor and denigrate their peers who “play like men” or look too masculine.

May 1, 2012 11:08 am

Medicine’s deadly gender gap (Macleans)

A lot of recent research exposes how little we know about the XX body. A report in the February 2010Annals of Internal Medicine found that women with implantable cardioverter-defibrillators (ICDs) are more likely than men to develop complications. The reason? Testing was done primarily on men, who tend to be physically larger. Stephanie Brister, a surgeon at Toronto’s Peter Munk Cardiac Centre, would like to see women-only randomized clinical trials for ICDs, though she’s not optimistic. “It’s not cost-effective,” she says. “More likely we’ll try to increase the number of women, then hopefully we’ll have a substantial representation with real information.”