This international womens day, dont miss a beat.

In the last week I have had cramps bad enough to require pain killers; I have lost enough blood to warrant taking a prescribed clotting agent twice daily. I have had to apply a menstrual pad to my undergarments while standing on the back of a rescue vehicle hoping like hell my (all cis male) colleagues didn’t notice what I was doing back there because we didn’t have time to stop. I haven’t taken any time off. I have looked pretty crap and asked to leave my 12 hour volunteer shift early (I couldn’t), and slept most of my spare time. But I haven’t taken a day off.
Because the STIGMA around taking time off for “lady issues” is so strong. It’s given the side eye. Is she really sick? Is she faking? Is she being a bit soft?  I’m TERRIBLE at taking a break and listening to my body, and I am not proud of it.

My biggest concern around this is that it is a symptom of a bigger problem. We need to START TRUSTING WOMEN.

• We need to believe women when they say they are in pain.
• We need to believe women when they say something isn’t normal.
• We need to stop assuming physiological symptoms are related to psychological issues.
• We need to believe women when they say they can’t keep going like this.

And I need to start trusting myself. 

Take a minute to think about the last time you listened to your body and did what you felt you needed to do to take care of yourself.

 

This lack of trust in women is seen in clinics where women are assessed for anxiety rather than cardiac issues, it is seen in pregnancy cases where women must undergo counselling and multiple consultations in order to gain permission for an abortion. This is a symptom of a bigger issue, and we need to start seeing it.

Usually I talk about women’s health at this time of the year in terms of gynae issues as they are close to my heart (metaphorically, not anatomically), but this International women’s day I would like to talk about our cardiac health. I have chosen this topic because it is relevant to both cis and transgender women, and is the biggest cause of Death of NZ women.

 



 

Cardiac health and disease is still widely misunderstood, most Australian women (and I suspect NZ women) are unaware that heart disease is a major women's health issue (Guillemin, 2004), yet 8 women a day in NZ are dying from cardiac arrest. And in US statistics since 1984, the number of CVD deaths for females has exceeded those for males.

The outcomes we are seeing in the cardiac cases of women are grim. Women with acute cardiac presentation have poorer outcomes than men, even independently of comorbidity and management of condition. This is despite the fact that women often have less obstruction of the coronary arteries. This out of proportion higher mortality rate is most easily seen in our population of younger women (Davidson et al., 2012).



Misdiagnosis and treatment differences in women compared to male patients are a researched issue. In the Framingham Heart Study cohort, half of the acute Myocardial infarctions in women were unrecognised, compared with being 33% unrecognised in male patients (Murabito, 1995). Pope et al. (2000) reported that women presenting to the emergency department with an acute Myocardial infarction were more likely to be discharged without admission than men, and misdiagnosis was a high risk for those who were under 55 years of age.  

Depressingly, in Canada, Spugeon (2007) found that even once correctly diagnosed, women patients were less likely to be treated by a specialist, transferred, or receive cardiac catheterisation than their male counterparts.



 

I am not here to put the blame entirely on doctors, we need to be aware that as women, we are more likely to underestimate our risk of cardiovascular disease (Hammond et al., 2007), we are more likely to rate our cardiac disease as less severe as our male counterparts (Nau et al., 2005). If we ARE experiencing pain or discomfort in our chest, we are less likely to report it (Canto et al., 2007), and more likely to delay getting help from a doctor (O’Donnell et al., 2006). In case this sounds like classic victim blaming I want to acknowledge that when you look at the statistics in how women are treated when they DO present with chest pain, it’s no wonder they are cautious about presenting at all. Key reasons for delaying treatment include “attributing symptoms to other causes fear of bothering anyone, embarrassment about a ‘false alarm’ and reluctance to call emergency medical services.” (Davidson, et al., 2012, p. 10).

So, how can we look after ourselves?
Be aware that during a heart attack women and men may both feel chest pain, but women are more likely to experience less common symptoms such as Back, Neck, Arm, or Jaw pain.

Women’s symptoms may include nausea, weakness, or a “sense of impending doom” (dread). (American heart association)



Head over to the NZ heart foundation to learn the facts about heart health and disease.

And look into your risk

 

If you want to support women, here is what you can do this year. Start believing. If someone you love is complaining of not feeling well, encourage them to listen to their body, encourage them to see a doctor. If that doctor is a jerk, or minimises concerns, encourage them to see another doctor.

This international women’s day if you are a woman, start listening to your body. Believe yourself, and if you feel like you aren’t coping, then understand that is real. Be kind to yourself, and seek help. Seek rest. Seek wellness. Pick one thing you can do this year that will help you live a little longer, with less risk.

This year I am choosing to promise myself the time to have 3 sessions of cardiac fitness in each week. How I will do that is by cycling to work, swimming, aqua jogging, aqua aerobics, and stationary bike exercise at home. I promise you this. I will look after my heart this year. Because women need strong hearts!

Picture courtesy of the American College of Cardiology

References

Canto, J. Goldberg, R. Hand, M. Bonow, R. Sopko,G. Pepine, C., et al. (2007). Symptom presentation of women with acute coronary syndromes: Myth vs reality. Archives of Internal Medicine, 167 (22) (2007), pp. 2405–2413

Davidson, P. M., Mitchell, J. A., DiGiacomo, M., Inglis, S. C., Newton, P. J., Harman, J., & Daly, J. (2012). Cardiovascular disease in women: Implications for improving health outcomes. Collegian, 195-13. doi:10.1016/j.colegn.2011.12.001

Guillemin, (2004). Heart disease and mid-age women: Focusing on gender and age. Health Sociology Review, 13 (1) (2004), pp. 7–13

Hammond, J. Salamonson, Y. Davidson, P. Everett, B. Andrew, S., (2007). Why do women underestimate the risk of cardiac disease? A literature review. Australian Critical Care, 20 (2) (2007), pp. 53–59

Murabito, J. M., (1995). Women and cardiovascular disease: Contributions from the Framingham Heart Study. Journal of the American Medical Women's Association, 50 (2) (1995), p. 55

Nau, D. Ellis, J. Kline-Rogers, E. Mallya, U. Eagle, K. Erickson, S. (2005). Gender and perceived severity of cardiac disease: Evidence that women are tougher. The American Journal of Medicine, 118 (11) (2005), pp. 1256–1261

O’Donnell, S. Condell, C. Begley, T. Fitzgerald, (2006). Prehospital care pathway delays: Gender and myocardial infarction. Journal of Advanced Nursing, 53 (3) (2006), pp. 268–276

Pope, J., Aufderheide, R. Ruthazer, R. Woolard, J. Feldman, J. Beshansky, et al. (2000). Missed diagnoses of acute cardiac ischemia in the emergency department. New England Journal of Medicine, 342 (16) (2000), pp. 1163–1170

Spurgeon, D., (2007). Gender gap persists in treatment of Canadians after heart attack. BMJ (Clinical Reseach Ed), 334 (7588) (2007), p. 280

In the half-light

My third child is six weeks old today.  For almost all of that time he and I have been living in a kind of dim twilight world, half-lit and full of unusual faint noises, as we navigated the Neonatal Intensive Care Unit (NICU) together.  We started out in Level 3, the most acute level of care, travelled across the ward to Level 2 for a few days, and then finally to Level 1, the Parent Infant Nursery.  I was discharged from neighbouring Ward 96 at Day 7, and baby came home late last week.

For those who haven't been to NICU, which will be most people, it's something of a shock, or at least it was to me.  Not only are the lights dim and the noises somewhat muffled, there are medical machines everywhere, including empty incubators cluttering the corridors at times.  Pings and beeps and whooshing noises in the more intensive rooms, rushes of laughing chatter amongst nurses and parents sporadically in others, loud alarms that catch you unawares occasionally.  It's like an old-fashioned library but with a few babies instead of many books.  You expect to be shushed at any moment.

The outcome for our whanau has been good.  Baby (nicknamed Early) decided to come eight weeks ahead of schedule (well seven ahead of mine, but that's a story for another time) and so he needed to cook for a bit longer basically.  The care and support we received astonished me, not just for the medical needs of my child but also for my health and wellbeing, mentally and physically.  I have come away very much wishing that every parent, new or experienced, could access this level of support for a period after birth if they wanted to; a lactation consultant checking in with all the breastfeederers every few days, friendly reminders that you could go eat lunch while a nurse watched over your child, help learning to do what they call "the cares" (take temperature, change nappy, top and tail wash, followed by a tube feed and later on breastfeeds), practical support with bathing these tiny creatures, comfy chairs that you could nap in, social worker and mental health workers available to come and have a chat.

Despite the excellent level of care and support coming home has very much felt like emerging from a long dream; not quite a nightmare, for us anyway, but not the kind of dream you'd really enjoy and lie in bed wishing you could dive back into.  The people who live in the half-light of NICU are of three kinds; exhausted stressed parents spending as many hours as they can at the cot-side while juggling everything else in life, efficient calm medical staff effectively going about their work, visitors who are only in the library to browse a little while and feel very much like interlopers.

There is an odd kind of camaraderie amongst the parents, I found.  Introductions are about baby names, gestation at birth, and how long you've been Here (ie in NICU).  It was days before I found out the name of a neighbouring mother in Level 1, and in the end I worked out the trick is to read their names on the bottles of milk in the fridge - every baby has stacks of sticky labels BABY OF LAST NAME, FIRST NAME that go on everything.  It sometimes felt like I had some extra status because my baby had been in Level 3 (the most acute level of care) and had come earlier than most (at almost 32 weeks).  People are careful not to ask too many questions about the health of the baby; no one wants bad news and there's always someone worse off than you.

I recognised a Level 1 mother by the toenails I had spied through a door in Level 2 - I remembered because they had taken all of my nail polish off before the emergency c-section but she still had hers and I wondered why (because acrylics I found out later).  Four of us in Room 18 bonded over weigh ins and hopes to graduate to the parent room (where you stay overnight with your baby) before going home.  We've arranged to keep in touch.

Now that we are home, and the sunlight comes through the windows in every room, my strongest memory is of the first room Early was in - Room 2 in Level 3.  Warm, dim, quiet.  Ratio of one or two nurses to each baby.  The gentle pings of oxygen saturation alarms.  Sitting in the lazy-boy staring at my impossibly small child through the incubator plastic, too dazed by drugs and the circumstances to do more than pat him from time to time, and sometimes only brave enough to pat the incubator as I dropped off pumped milk.  The incredible kindness of the nurses and staff.  The sense that the baby in the neighbouring room had it much much worse.  Waiting for bad news that didn't come, and feeling lucky and grateful and humbled.

I hope you never have to go to NICU.  I wish I hadn't.  And I am very very glad it exists.

Wanted: Health Minister who reads their own research

Content note: discussions of transphobia and it's impacts, focussed on the recent political discussions about trans* healthcare.

There's so much to find troubling about National calling life-saving healthcare for trans* people "nutty" and Labour leadership failing to stand behind regional conferences voting to have funded gender reassignment surgery on the table.

For our health minister to be so poorly educated about trans* healthcare needs is horrifying.  It's increasingly obvious that transphobia, transmisogyny, gender policing and the institutionalised discrimination and stigma that people from marginalised genders experience kills.  It kills by making employment and housing less accessible.  It kills through people seeking solace in drugs and alcohol.  It kills through increasing vulnerability to being targeted for intimate partner and sexual violence.  It kills through creating a climate where violence towards trans people is invisible, enabled and lethal.  It kills through people being unable to contemplate going on living.

The Ministry of Health fund our best research into trans* needs so far, the Youth 2000 research where thousands of secondary school students are asked questions about their experiences.  Seems our Health Minister didn't bother to read the trans* section - 20% of our beautiful trans* secondary school students attempted suicide in the previous 12 months.  That compares with 4% of other kids.  40% of trans* young people had "significant depressive symptoms" and half had self-harmed in the previous 12 months.

But the Labour leadership rush from the possibility of championing trans* rights to life-saving healthcare is equally disgraceful.  Andrew Little's happy with his gender.  David Shearer didn't know what gender reassignment surgery was.  Stuart Nash says the issue isn't important to the people in New Zealand.  I'll save special disdain for every(gay)man Grant Robertson though - he doesn't feel strongly about life-saving surgery apparently.  Must be nice to be that kind of Rainbow champion.

(In the queer press Grant Robertson is "absolutely committed" to the best possible trans* healthcare services.  I guess he thinks queer people are stupid.)

As usual, public debate about a socially contested issue - where there is real ignorance, I suspect, amongst the majority of the general cis public - is an opportunity for social change.  If at an incredibly hurtful cost for trans* and gender diverse peeps, as well as pain for those of us who love them.  And Jan Logie has stepped up to the gender diverse plate, not for the first time, to show us what a real Rainbow champion looks like.

She's pulled together an LGBTI rights MP group to educate, provide leadership and push for changes in legislation.  Beyond Marriage Equality.

So, improving access to life-saving trans* healthcare, including hormones, counselling and surgery.  Stopping once and for all state sanctioned (and funded) genital mutilation of babies and children in the name of gender policing.  Creating increasing space for queer people of colour to create and determine spaces which are culturally appropriate for them.  Providing inclusive and positive information about sexuality, sex, gender, relationships and all kinds of bodies to every young person in Aotearoa.  Naming biphobia as a real thing, leaving bi people with the highest rates of mental health difficulties, sexual violence and intimate partner violence of all sexualities.  Dealing with the homelessness risks for queer young people.  For starters.

First though: Writing the job description for the next Health Minister - whether they come from National or Labour - and making sure "understanding the health needs of the most vulnerable" is bullet point number one.

On her bike

For a bit of 2012 and most of 2013 I borrowed the Auckland Frocks on Bike bike to see if I could get around on two pedals.  I've written about that experience here.  In November last year I decided I'd been dipping my toes in for long enough and invested in a bike, complete with basket, bike lock, rear rack, and good intentions galore.  My mum gave me The World's Largest Bike Bell.  I decorated the basket with some flowers from a broken plastic lei.

It's actually going well.  I have worked out I have poor balance (I fall off quite a bit, have trouble with take off too), and that's not all that likely to go away.  I'm also rather scared of going fast, so I use the brakes a lot going downhill.  People smile at me more when I have the basket on, and it's quite delightful to be able to get around my suburb and a bit further afield and say hello to those I meet on the street; something I could never do in a car.

What I've worked out is that when I cycle I feel I am a part of the neighbourhood I'm moving through, with all my senses, as opposed to being separated from it by the steel and glass shell of a car.  And that's a good feeling.

Cycling has become an important part of my self-care regime, along with nice-smelling stuff from Lush, visits to Savemart, a daily dose of anti-depressants, cuddles from young children of my acquiantance, reading novels, naps, eating cake, a monthly visit to a psychotherapist, and saying a cheery hello to people on the street.

At Suffrage Day last year my colleague and friend Pippa Coom, deputy chair of the Waitemata Local Board, spoke at Khartoum Place about what a bicycle meant to women in the 1800s; freedom.  I must admit I initiatlly thought that was a bit OTT, but on reflection I can feel that freedom whenever I ride.  For me it's a very different freedom from that of my foremothers and -sisters, but still it is freedom that is meaningful to me now.  Freedom from relying heavily on oil, freedom from traffic, freedom from being shackled to using roads to get around (cycleways through parks FTW!), freedom to experience the city around me directly.  Freedom to park for free, and get some sneaky inadvertent exercise, and get more sun, and ring a bell at people with good reason.

I'm not in this for health, although cycling does help me feel better.  I'm not in it to save the planet, because I know I can't do that on my own however much I can set an example.  I'm not in it to save money, appreciated consequence though that is.   I'm in it because in my current circumstances it is simply the best way for me to get around most of the time, and it helps me to feel well.

The bike I was previously borrowing felt like it acquired a name after a while (Bertie), but I haven't taken the step with the new one yet.  I've thought about Decca, and Agnes, and Ingrid, but I'm open to your suggestions.  Bruiser or Freedom seem more appropriate some days!  Feel free to leave your ideas in comments.

There is no depression in New Zealand

There's a lot of talk at the moment about mental illness, and particularly about assumptions made that really bad things (like mass shootings) are carried out by people with mental illnesses.  I was part of such a discussion today, and I paused a bit, then told the small group discussing it that I have a mental illness.

I explained, after an awkward silence, that I take medication every day for depression, because I seem to have a chemical imbalance in my brain*, much in the same way that I take medication every day for asthma, because I seem to have chronic inflammation in my bronchioles.  I see a counsellor once a month to help me with tools to build my mental fitness, in much the same way that others might go to a gym for their physical fitness. It was surprisingly hard for me to talk about.

I think it's natural to assume that people only do really bad things because they are not in their right mind at the time; a "psychotic break" perhaps.  And I'm sure sometimes that is the case.  But it does seem like often it's a convenient way to Other, to dehumanise, to put the perpetrators of bad deeds at a distance from ourselves, so that we don't really have to explain or understand why. 

Via a Facebook friend I happened to stumble across this interesting blog post today, which included the timely quote:

Instead of examining what made it possible for [Anders] Breivik to unleash his barrage of racial hatred (he was vehemently against immigration by racialized bodies and supposed ‘takeover’ of Norway through this immigration’), he is excused and deemed insane, being sent to psychiatric care instead of prison. The explanation for his violence – he had a psychotic  ‘break’, a break from his normal civility and a break from an ordered society that would never breed such violence.

Never mind his high levels of planning and execution, never mind that he was actively a part of White supremacist organizations with similar views – White society is civilized and non-violent, so he must have been crazy. Madness is used here as a way of explaining away violence within White bodies and White society. It is not the norm, it is a break from it. 

And then there is this response to the Sandy Hooks shootings, and the leap to assume a role for mental illness there too, You Are Not Adam Lanza's Mother, including this:

The reality is that there is no such observed link: “after analysing a number of killers, Mullen concludes, ‘they had personality problems and were, to put it mildly, deeply troubled people.’ But he goes on to add: ‘Most perpetrators of autogenic massacres do not, however, appear to have active psychotic symptoms at the time and very few even have histories of prior contact with mental health services.’” And most people with mental illness are not violent, although they are far more likely to be victims of crime.. [their emphasis]

I don't really know how to finish this post other than to say it has been a difficult day.

---

I've just edited this, a few minutes after publication, to take out the picture and reference to some of the work the Mental Health Foundation is doing because I don't want to confuse things by writing about them in the same post.  Hope that makes sense.




*  This is my experience of mental illness, and it won't necessarily reflect how others with mental illnesses see their own experience.

An announcement from Wellington Rape Crisis

Sad news from Wellington Rape Crisis - they have had to cut their services down by a day a week due to funding shortages.  The above YouTube video succintly explains the situation.

They have a Facebook group and a website, and you can also donate to help raise funds for Wellington Rape Crisis via Fundy here.  And for those who prefer cheque or bank deposits, the info on that is here.

Disability and Queer Issues Part 1

The following is an edited version of a short talk I gave on disability and queer issues to a queer, mostly studenty, audience. It is limited by the short time I had to speak, as well as my own perspective. At the end I touched on some aspects of movement building and common experiences, however I have ended this post quite abruptly before that as I'd like to explore these in more depth in a later post.

As a queer disabled person, the disadvantages and exclusion you face end up being multiplied. It’s hard to find queer friendly housing, and it’s hard to find accessible - which may mean quiet or dry or wheelchair accessible - housing. If you need both, you get slammed. Queer friendly healthcare isn’t that easily come by - but try finding queer friendly healthcare that is accessible and includes the specialist knowledge you might need. Queer people generally get useless, inappropriate and often outright damaging sex education. Disabled people can get the same, or often don’t get it at all, perhaps because we are assumed to be non-sexual, because we are removed from those classes for extra tuition, because it is not offered in a way we can understand or interpret or because it is not appropriate to our bodies. Again, the effect is multiplied.

Queer spaces are too often inaccessible - even on the most basic level of being wheelchair accessible. It's not acceptable, and constitutes a 'not welcome' sign on the door for many disabled people. And whilst this isn't okay anywhere, I think most of us here know how essential queer spaces can be, and that they're often the place you go after being excluded from anywhere else. Accessibility needs can be quite varied, though - to give one personal example, I struggle with the reliance on bars and clubs as queer spaces because I have problems in noisy environments. I'm happy that more and more alternatives are being offered, but there's a long way to go. Accessibility is often overlooked in event planning, but it needs to become as routine as booking a room or putting up posters.

 
The next thing I want to talk about is family and relationships. The picture above is from the movie Milk in which this young person calls up Harvey Milk for help as his parents are about to send him off to be degayed. He’s advised to run away, and get to a big city. The image then zooms out, revealing he’s a wheelchair user. That story had a happy ending, but many don’t.

It’s hard enough escaping from abusive or bigoted family - but if you have limited mobility, if sleeping on a couch isn’t possible for you, if you need personal care provided by your parents, if they’re the ones who take you to medical appointments, if public transport is inaccessible and your escape can be attributed to your disability then it’s a whole other story. You’ve probably heard about parents of disabled adults fighting to be paid for carework in the news recently. Mostly it’s been fought from the angle of these parents’ rights - which is important. But it’s also important that disabled people are not forced to live with family members longer than they would otherwise choose for financial reasons.

Similarly, there can be pressure for disabled people to stay in relationships longer than they otherwise would if they are meeting support needs - this includes abusive relationships, but also those which have simply run their course. I think this issue is particularly important to the queer community, not just because abuse in queer relationships is under recognised, but because we place a lot of value on the fight to be accepted as in relationships, and we need to understand that for some leaving can be just as much as a struggle.

The sexuality and gender identity of disabled people can be linked to their disabled status in a way which pathologises or dismisses that identity. For example, asexual disabled people are assumed to be examples of the belief that ‘disabled people don’t have sex’ rather than having their identity acknowledged in its own right. Disabled lesbians are assumed to be lesbian because they can’t get a man. Genderqueer disabled people can be assumed to be confused or lack understanding of social appropriateness.

That said, I think queer people can often be unaware of the complex ways sexuality and gender identiy can be linked to disability for some people. To give just one specific example, a lot of autistic people see themselves as outside the gender binary. And a number of them would never identify as genderqueer or join groups catering for queer and gender diverse people (though of course some do!). They might see their gender identity as an extension of their autistic identity, but not talk in the terms or feel welcome in the spaces that other non-binary people do.

Disabled queer people of course experience similar issues to many who experience more than one form of oppression. The more acceptable norms a person fits, the more easily they can get away with breaking others. Sometimes this starts externally, and becomes internal, with people trying to hide one part of themselves because it is all ‘too much’.

Okay, shoe time:

Say (to make it simple) if you were at a queer women’s group, and a woman walked in wearing one of these pairs of shoes. You’d probably assume it related to her identity in some way. If I gave you two stereotype hairstyles, I’m sure you could match them with the shoes - and you might make some assumptions about the type of person she is and what she does with her time.

 I look at those shoes and see one pair I could never ever conceive of wearing anything like them, because I’d fall over, and another that I might manage but would be a struggle. I don’t see identity; I see functionality. But so much of identity in the queer community is assumed to be tied up with what we wear or how we look which excludes those of us who have limited choices in this matter.

Related to this is the label of ‘assimilationist’. To me, an assimilationist position is one in which someone seeks to advance the position of their own group whilst leaving the system intact, someone who (for example) focuses on fighting for rich white gay men to have the same rights as rich white straight men, and thinks that’s as far as it needs to go. But I’ve seen it directed at individuals for focussing on meeting personal needs or living a conventional lifestyle.

The truth is, we all do what we need to survive in this society - but the needs of some disabled people may not be recognised as needs. Having - say - a quiet living space or a car because you need it (or even if you don’t need it) isn’t a problem - assuming that because you have the world isn’t broken is. Disabled queer people can also find themselves in a complicated position when it comes to breaking or conforming to stereotypes. The same action can be viewed as challenging stereotypes in one community, but upholding them in others. And therefore we really need to stop making this about our lifestyles, about how we live and what we own, because those don’t change anything. But what we fight for - and how we fight it, collectively - does.

Language and concepts associated with disability - intellectual disability and mental illness in particular - are often used to oppress queer people. Two particular examples come to mind; some of you may remember Constance McMillen, a young person in Mississippi who was not allowed to take her same sex partner to her school prom. After public pressure, the school seemingly relented, only trick to her into what was dubbed a ‘fake’ prom with her intellectually disabled classmates, whilst the so called ‘real’ prom went on elsewhere. Meanwhile in New Zealand a woman recently received an apology for years of medical abuse - including electro-convulsive therapy - resulting from her sexual orientation.

And I think it’s so important we’re careful how we respond to these. Our response shouldn’t be “this abuse was so bad because she wasn’t really mentally ill” or “it was wrong to segregate her from the rest of her school because she’s not intellectually disabled” but to acknowledge that people are on the receiving end of similar forms of oppression for ostensibly different reasons and we need to fight it together.

Guest Post: Abortion & maternal mental health report

Many thanks to Family Planning NZ for allowing me to publish the below from their e-newsletter:

A report released in December 2011 by the United Kingdom National Collaborating Centre for Mental Health was commissioned to review the best available evidence on any association between induced abortion and mental health outcomes, and draw conclusions where possible.  The report concluded that, on the best evidence available: 

• The rates of mental health problems for women with an unwanted pregnancy were the same whether they had an abortion or gave birth.
• An unwanted pregnancy was associated with an increased risk of mental health problems.
• The most reliable predictor of post-abortion mental health problems for women was having a history of mental health problems before the abortion. 
• The factors associated with increased rates of mental health problems for women in the general population and following abortion were similar. 
• There were some additional factors associated with an increased risk of mental health problems specifically related to abortion, such as pressure from a partner to have an abortion and negative attitudes towards abortions in general and towards a woman’s personal experience of the abortion. 

Here's a link to the full PDF of the report.

Jennifer Lee on the case for Fat Activism

Great piece by Melbourne academic Jennifer Lee: A big fat fight: the case for fat activism 

My left-wing, friendly and kind GP says, “You’re bigger than you were last time so it’s harder for me to get this in place,” as an apology for groping around during a pap smear – an apology that blames my body for her less-than-perfect technique. 

That’s a subtle example, because I try to choose my medical professionals carefully to avoid the standard fat prejudice. It demonstrates that sometimes we are hit with fat prejudice in the most vulnerable or intimate situations. Why aren’t medical students trained to deal with fat bodies? Why isn’t medical equipment generally made for different kinds of bodies – fat ones included? Fat people are sent constant messages that they are wrong, that they need to change, that the world around them is fine and doesn’t need to cater for them.

...

Still, in some moments I do find myself wishing I were thin. But I catch myself and think, “Why do you want to be thin in this moment?” The answer is inevitably about thin privilege. If fat was the sought-after attractive body in the media, if doctors separated fat from disease, if big clothes sizes were available everywhere, would I ever want to be thin?

When I speak about thin privilege, I am talking about the advantages that thin people in Western culture experience, such as being assumed healthy and having a wide array of clothes available, as well as a body that aligns with dominant ideas of what is attractive. It’s time to acknowledge thin privilege the way the Left has acknowledged white privilege, class privilege or straight privilege.

Vaccinations and Beneficiary Bashing

And now the government is considering penalising beneficiaries who don't immunise their children.

Just as I believe access to free contraception is a good thing, I think vaccination is a good thing. I believe parents should adhere to the regular vaccinations schedules, except in rare and specific cases.

This has nothing to do with vaccinations.

If the goal was to make sure all children were vaccinated, as well as making it easier for parents and dispelling some of the myths, the government could consider a policy like that in some regions of the US where children are unable to attend school if unvaccinated. I have significant concerns about such a policy. But what it would do is (a) put pressure on parents (all parents) to have their children vaccinated, and for those who didn't limit the potential for communication of diseases to other students. That would be the more sensible policy for a government concerned about vaccination rates.

This has nothing to do with vaccinations.

But it is quite clever. On the one hand, it's the usual beneficiary bashing, introduction of nasty punitive measures, and the implied slur that beneficiaries are irresponsible, illogical people who don't care about the health of their children (just like they're apparently all sluts who are popping out one child after another to play the taxpayer, or something).

But I think there's something else going on. There's been an outbreak of whooping cough in my low-income suburb. Obviously lack of vaccination is a significant contributor, as is sheer chance, but it also thrives in crowded conditions. There's a reason it happens in places like this rather than wealthy suburbs, and it ain't because parents are stupid.

Rheumatic fever - for which there is no vaccination - affects young Maori people at vastly disproportionate rates. Preventative measures, however, are well known and documented, including less overcrowding and better quality housing. And that's not even touching asthma rates and severity, depression and repeated contraction of minor illnesses.

But rather than tackling these, the focus seems to be not just on the beneficiary bashing, but on the framing of health issues amongst beneficiaries as issues of personal irresponsibility and ignorance, rather than a public health issue which needs to be tackled on a structural level. And facilitates both the bashing and the sticking-one's-head-in-the-sand.

So yes, parents, it's generally a good idea to vaccinate your children. But to the government, what would be a good idea for you to do is to stop screwing people over, quit the beneficiary bashing and start tackling the fact that (poor, Maori and Pacific Island in particular) families are living in shitty, cold, uninsulated, overcrowded housing, and it's doing no-one's health any good.

i knew it:

... new research shows that it's possible kids can be too clean.

You read that right.

That's because all of the soap dispensers, hand sanitizers and alcohol-tinged wipes could be robbing our kids from exposure to the germs that help strengthen their immune systems.

According to new research done on mice, increasing exposure to germs helps develop the immune system, thereby preventing allergies and other immune-related diseases like colitis and asthma later in life.

i was always one to not fuss too much about dirt. when kids are at the crawling stage, they spend most of the time finding unmentionable little bits and pieces on the floor and promptly popping them in their mouth. now while i certainly did my share of vacuuming and sweeping, i certainly wasn't worried about what went into their mouths at that age. as long as it wasn't something they were going to choke on, i just put it down to immune-system-building activities.

i remember some guy trying to sell us a vacuum cleaner that doubled as an air purifier. he went through his whole spiel about the benefits of purifying the air, but it was obvious what the problem was: the minute you walk out the door, you're walking in unpurified air. but your system is used to purified air, so the chances of getting sick become that much higher, since your immune system isn't going to cope so well.

i'm not saying that we should all live in filth, or that cleanliness is not next to godliness. i just think it's not worth being overly fussy. i don't use water filters in nz - really can't see the point. i definitely drink boiled water when i travel - a healthy precaution - but generally there isn't much point here. better to let your body build up immunity whatever is in our normal water supply. (but i recognise that there are some communities in nz that aren't getting adequate quality water, which is really a shame on us that we don't spend the money to supply it.)

i have to say though that one of the worst immunity-building times is when kids start childcare or kindy. it's like they're sick every 3 or 4 weeks for the next 6 months, as their little bodies try to cope with all the new varieties of germs that other kids carry. i'm particularly glad that this period of my life is over and sympathise with others who are going through it.

Right to Life's candidate questionnaire

Feel free to answer for yourself in comments, regardless of your intentions to stand for Parliament :-)

 If elected to Parliament at this general election, would you:

1. The Crimes Act states that an unborn child does not become a human being until it is born. Would you support legislation that would give legal recognition to the status of an unborn child from conception as a human being endowed with human rights, the foundation right being an inalienable right to life?

2. The Care of Children Act provides that a girl under the age of 16 may have an abortion without the knowledge or consent of the parents or guardian, Would you support an amendment to the Act that would protect parental rights by requiring that an abortion may not be performed on a girl under 16 without the consent of the parents

3. The Care of Children Act provides that a girl under the age of 16 may have an abortion without the knowledge or consent of the parents or guardian, Would you support an amendment to the Act that would protect parental rights by requiring that an abortion may not be performed on a girl under 16 without the knowledge of the parents.

4. Oppose legislation that would give doctors the right to kill or assist in the suicide of their patients [Euthanasia].

5. Support the right to life of every individual from conception by opposing embryonic stem cell research that entails the destruction of human embryos.

6. Uphold the state of marriage as being exclusively for a man and a woman. 

 What does number 6 have to do with the "right to life"??

Guest post: Let's have a look at those statistics

By La Ranita, cross-posted at ALRANZ's blog

The annual New Zealand abortion statistics were released on Friday. There are some in this country who would (and do) tell us that these statistics are a shocking reflection of all that is wrong in the world, that they show that women are promiscuous slatterns who have no concern for their actions because they can easily terminate any unwanted pregnancy. That young girls are being sent by their guidance counsellors for secret abortions at an alarming rate. That every abortion represents the loss of the next Steve Jobs.

Well, let's have a look at some other statistics shall we?

• Of all of the abortions that occur worldwide each year, almost half are performed by unskilled individuals, in environments that do not meet minimum medical standards. More than 97% of these unsafe abortions occur in developing countries.

• Ninety-two percent of abortions in developing nations are unsafe.

• Worldwide, girls aged 15-19 account for one in four unsafe abortions – that adds up to five million each year.

• Internationally, approximately 40% of women who have a clandestine abortion experience complications that require treatment.

• An estimated five million women are hospitalised each year for treatment of abortion-related complications, such as haemorrhage and sepsis.

• Worldwide, an estimated 68 000 women die as a result of complications from unsafe induced abortions every year – about eight per hour. This fatality rate (approximately 367 deaths per 100 000 unsafe abortions) is hundreds of times higher than that for safe, legal abortion in developed countries.

• It is estimated that every year nearly 5.5 million African women have an unsafe abortion. As many as 36 000 of these women die from the procedure, while millions more experience short- or long- term illness and disability.                     (Sources: the Guttmacher Institute and UNFPA)

I don't know about you, but I know which set of statistics is the one that upsets me. Accessing a legal and safe abortion should not be shameful, it should bear no stigma, and it should not require negotiation of legal hurdles. It should be a basic human right.


***


This is part of a week of Pro-Choice Postings hosted here at The Hand Mirror starting on Friday 28th October 2011.  For an index of all the posts, being updated as they go up, please check the Pro-Choice Postings index.  And if you'd like to submit a post for cross-posting, guest posting or linking to please email thehandmirror@gmail.com. 

Quickie: 2010 Abortion stats out

ETA:  Here is the link to the actual 2010 stats, sorry I got a bit confused with the earlier version of this post. Here's ALRANZ's media release on the matter too. /ETA

Many thanks to ALRANZ for putting up online the Abortion Supervisory Committee's report on the 2010 abortion statistics.

I haven't had time to read it properly yet, but a quick scan shows the 2010 abortion ratio was the lowest since 1999.

In my opinion a drop would be good if it meant that more people had control of their fertility in a way that meant they could avoid unwanted pregnancies.  However it is a great worry if the drop is the result of problems with accessing abortion services, either because of logistics or because of societal pressures against abortion.

***


This is part of a week of Pro-Choice Postings hosted here at The Hand Mirror starting on Friday 28th October 2011.  For an index of all the posts, being updated as they go up, please check the Pro-Choice Postings index.  And if you'd like to submit a post for cross-posting, guest posting or linking to please email thehandmirror@gmail.com. 

So how does your lady garden grow?

This post is explicit, and links to pages which feature explicit photographs. Feel free to look away.

I admit to a passing interest in fashion trends. Well ok, maybe that’s exaggerating my interest. So this may not be breaking news, but I’ve been thinking about it since chatting with a lesbian friend 14 years younger than I am.

We were talking about our bodies, and how we felt about them, and she said she shaved all her pubic hair. I asked her how her lovers felt about this, and she looked shocked and said “they all have too, of course.” When I told her I have never slept with a woman who shaves all her pubic hair, she looked shocked again.

Now most of her lovers have been her age or younger, mixed racially, not identifying as feminist.

Nearly all of my female lovers have been my age or older, mixed racially, identifying as feminists (what can I say, women who love women and don’t like gender oppression, *sexy*).

So there’s a generation gap going on here, and possibly a different analysis about how women look after our beautiful bits between feminists and non-feminists.

Before anyone assumes I’m saying “feminists can’t shave their pubic hair”, let me clarify. Growing pubic hair is one of the changes our bodies go through when we move from childhood to adulthood, and I don’t know about you, but I love being an adult woman. Which includes, for me, loving pubic hair.

A couple of years ago in Wellington’s Comedy Fest, the only humour in common from all the wonderful female comics I went to see were “jokes” about their pubic hair being revolting. This is the bit that is anti-feminist as far as I’m concerned – cultural norms which tell us our ordinary bodies are disgusting and a return to a pre-adult look for our genitals is a must. But our bodies, including our pubic hair? Ours to do what we wish with, of course. Kinda a baseline for feminism.

Quite where our wishes come from of course is another matter. Pubic hair fashion, like all fashion, has changed over the years and most agree that Penthouse featuring shaved genitalia in 1970 kicked off a cosmic shift in hair removal.

90s porn culture targeted a new area of hair growth on women and deemed it unattractive and unacceptable. In fact, trimmed, shaped or completely removed pubic hair has become normative. It is difficult many to remember the previous aesthetic, an aesthetic that did not require a woman’s vulva to be shaved, waxed or shorn to be considered “attractive” or desirable.

The “attractive” thing is clearly not just heterosexual in gaze, as evidenced by my friend. It’s also strongly aged. One national survey in the US found that 38% of women aged 18-44 cf 3% women aged 55 and older believe most men prefer a manicured look to their pubes. And what men want is definitely part of selling the package of pubic maintenance to women:

Most women place a good deal of focus on their pubic hair not only for themselves but for their partners as well. In fact, many women are willing to indulge their partners when it comes to pubic hair styles. Why not?

In a recent study:48% of men preferred their women to get rid of it all.

29% of men said they preferred their women to be natural — that being trim and neat but not bare.
16% of men wanted their women to have a little tuft of hair or a patch — would that be a ‘soul’ patch, boys?

The rates of “heterosexually active men” who answered this small online survey were similarly clear about preferring little or no pubic hair, and the reasons for their preference:

Making oral sex “better”? I guess I have nothing to compare it with, but I’m not really sure how much “better” giving oral sex could get to be brutally honest. One in four men surveyed liking the woman they are having sex with to look younger or virginal while they are having sex with them? Just creepy.

Pubic hair grooming is big business, with a whole heap of options available. Which means companies making the tools to tend to our “lady gardens” can make awesome adverts:

Next time I’m-too-scared-to-call-my-beautiful-vagina-labia-and-clitoris-by-their-non -euphemistic-real-names I’m using tulip. But wait, there’s more:

But the most disgust expressed? The bizarre “neighbourhood is open” series, complete with canned laughter:

I’m really interested in how other people feel about this. But completely uninterested in misogynist expressions of disgust about women’s bodies, so please don’t comment if that’s your thing.

Expanding and contracting and expanding again

I was so sure it would be the Tuesday.  No particular reason, just a hunch. 

Due date was the first or second of September; the midwife seemed to waggle back and forth between them.  I was full and heavy, the most pregnant I'd ever been before.  Maybe I thought Tuesday because I wanted the pregnant part to be over.  I was very apprehensive about the labour part though, so I just kept pushing it away in my mind. 

Magically this process was going to be:

1. Pregnant
2. ????
3. Baby and mother healthy and well

I hadn't laboured at all with Wriggly, not a single contraction, in a story I told in three parts several years ago.  I was partly looking forward to giving labour a go, but pretty nervous, especially in regard to what I consider one of the scariest medical words in the English language, "crowning".  And I knew if labour didn't come on spontaneously soon it would be off to surgery for another sunroof delivery, with nary a uterus quiver experienced, and no chance of labouring with any future pregnancies either.

By 10.30pm I'd given up waiting to feel my first ever contraction and I headed to bed.

Wheels keep turning

I've been a bit poorly for the last few months, nothing major, just bits and pieces exacerbated by doing too much.  When I disappear from here that's often why.  Trying to avoid getting really sick by being slack about whatever I can get away with being slack about.

Someone said something to me about my health a month or so back that's been bouncing around inside my brain, making me alternately angry or worried;  that if I fall over then the whole family will fall over.  And I feel that's not fair.  I'm not actually the primary caregiver for the kids, their father is.  I am the main earner currently, but I have lots of sick leave and work in an environment where taking sick leave when you need to is actively encouraged.  So financially we would be ok if I fell over for a while.

That's the angry part - that lack of recognition of the work my partner does to keep the family and the household wheels turning, and the expectation that somehow I am secretly doing it or something, because I'm the woman.  Recently we've had a few events that both of us have needed to attend, mainly Local Board work, and at every one someone has said to me "where are the children."  No one has asked their father, even though a lot of these people know he is the main caregiver.  It's a way of making conversation with me, but not with him, it seems.  The difference is not what we do, but other people's expectations of our roles, based on our genders.  That makes me a bit grrrrr.

The worried part is that wormy little voice in my head that whispers "what if it's true"?  If I get sick will the wheels fall off me, and the household, and my partner, and the children?  How would we cope if I was down for a week, a fortnight, a month, longer?  The money would be ok in the short term as my income would keep coming, but the costs would increase - not just medical but potentially increased childcare costs on the three days a week I do most of the childcare.  If I had to miss Board stuff that could be disastrous not just for me but also for the other centre-lefty on our Board who won't have anyone to second motions or back him.  Which would in turn create stress in the family, seeing as how that other centre-lefty is also my partner and the stay home dad in our house.


Were I religious I might pray.  As I'm not I just hope.  Hope that nothing goes wrong with this precision vehicle we are driving, which is finely balanced and requires some odd care that other families possibly don't; hope that we can continue to just keep ahead, financially, of the petrol and maintenance costs; hope that none of the tyres gets a puncture and that the fan belt holds together; hope that the wheels will just keep turning, turning and turning, for another week, another month, until things get easier.

Pro-choice round-up for Court of Appeal decision this week

Pretty momentous legal decision against Right to Life this week at the Court of Appeal [PDF], which I haven't had time to read, so here's a round-up with heaps of choiceness written right into it:

Abortion Supervisory Committee v Right To Life New Zealand Inc - Hazel Parson at Hazel Parson

Judicial sense on abortion - Deborah at The Lady Garden - also at her own blog

Human right to terminate unwanted pregnancies endorsed by Court of Appeal - Luddite Journo at The Hand Mirror - also at her own blog

The hills are alive with weeping anti-choicers - Octavia at Octavia's Spitfire Emporium

FUCK YEAH COURT OF APPEAL - QoT at Ideologically Impure

Victory in RTL vs ASC case (and 'informed consent') - at the ALRANZ blog

Abortion rights look safe - Idiot/Savant at No Right Turn

Court of Appeal rules on abortion laws - David Farrar at Kiwiblog DON'T READ THE COMMENTS!

Added 8pm Friday night:

Bring it on - Idiot/Savant at No Right Turn

NZ:  Right To Life Loses its Court Case - Craig at Red Queen

Let me know of anything I've missed, perferably in comments, and I'll add it in when I get a chance.  These are currently in no particular order, but I will put new additions at the bottom once there are some.


Image from here.

SST and their scenarios

Gotta give the Sunday Star Times credit, at least they're trying to make their scare-stories about parents not having complete control over their teenagers a little more equal opportunity. So whilst girls were disproportionately targeted last week, today they've come up with some hypothetical scenarios aimed at increasing the net of vulnerable teens they're concern trolling on behalf of:

A counselor takes a student to a doctor who prescribes Prozac. "Once the student has seen the doctor, the responsibility for that decision is the doctor's. Counselors don't administer medication."

Actually, this is the one I'm closest to sympathetic to. Prozac does carry medical risks, particularly early on and in teenagers, and I'd like someone to be monitoring their health - and ideally that would be a main caregiver. But the counsellors aren't objecting to that - they're simply saying that it's the doctor's responsibility to assess the risk and take precautions. Seems eminently reasonable to me. And if a teenager needs a medication (and yes, I do have concerns about how antidepressants are prescribed - but I also know they can be a lifesaver) isn't it better they get it?

A student has suicidal thoughts. "Our job is to make a risk assessment. If our assessment is the kid really is at risk then there's no choice – the parent must be told. When kids are genuinely at risk, there's no fight in them, and they actually want someone to take responsibility for their safety."

They make a risk assessment? Can't have that. That would make too much sense.
Look, they've said that they will inform parents if there is a risk (I would hope/assume other procedures would come into place in certain circumstances, eg abuse). Sometimes people have vague, fleeting suicidal thoughts when things are going badly that they have no plans to act on. Of course expressions of these need to be taken seriously until it's determined what the risk level is, but isn't it best for teens to be able to express them and have help dealing with them?

A student considers a sex change. "If there is no indication of serious imminent harm, then there's no choice; we can't tell."

Oh yes, here's the ultimate scare story! Note the really vague term 'sex-change' which most people are going to associate with surgery. Let's get this clear. Little Bobby is not going to go to school one day and come back as Roberta, minus a penis. Surgery happens at the end of a long, long process, and is rarely publicly funded. There probably isn't even any medication involved at this stage (and if there is, see Prozac argument above). What we are talking about is teens discussing their gender identity in a supportive environment. I think that's fucking fantastic - I can't imagine that anyone would have felt able to to that at my high school.

And, yknow, gender identity can be very fluid for teenagers. Some people will know that they're not cisgendered from a very young age - but others will only start to explore the idea at puberty or later. And of those that do, some will be trans* and take medical steps, others will not but identify differently to how they were assigned at birth. And some will be cisgendered but have been exploring - say - an uncomfortableness with gender roles they were expected to take. Imagine being outed to your parents at such an early stage in your exploration, when you're really not sure what to tell them.

We didn't have counselors in my high school, so this is quite a new concept to me, but if they're providing a safe space for teenagers to talk about these issues, conducting risk assessments to keep them safe but not breaking their privacy unnecessarily, then this is a fantastic and needed service. Shame on you, SST, for your scare-mongering. I can guarantee that if you manage to destroy the confidentiality, kids are going to die because of it.

I also recommend Boganette's post on Judith Collins' call for a law change.