Cruel Summer*
Why Do Congress and the Court Have to Be So Mean**
We’ve all been so pummeled by bad news in the last few weeks; it’s emotionally and physically draining. I wish that I had some happy stories to share where the good guys win and the bad guys get their comeuppance. Unfortunately, that’s not the timeline we’re living in. Instead, what I have for you is a round up that includes the big stories and some of the less highly publicized pieces of bad news.
We all know the Supreme Court handed down a series of dreadful decisions this term, the scariest—in my opinion—being the ones that seemed designed to let our President operate by fiat. The Court’s unwillingness to check his power has me so anxious that the rulings that I would normally be most concerned with—the ones relevant to this newsletter—registered much lower on my “I-need-a-Xanax” scale. But there were a lot of decisions related to sex, and they were pretty much all bad.
The Court allowed states to block Planned Parenthood (and therefore other reproductive and sexual health clinics) from their Medicaid programs. This will leave people who rely on Medicaid for things like contraception, HPV shots, cervical cancer screening, and breast cancers screening with far fewer providers. Remember, Medicaid was never paying for abortions, but Planned Parenthood was providing other important health services.
SCOTUS also upheld a ban on gender affirming care for youth using the most convoluted argument. (Seriously, the majority had to stick their heads pretty far up their own asses to get to this one.) The court basically said this case wasn’t about whether transgender people constitute a protected class because the Tennessee law in question wasn’t based on sex, it was based on diagnoses. It’s true that the law didn’t single out transgender people: it just removed gender dysphoria, gender identity disorder, and gender incongruence from the list of treatable diagnoses. Of course, these diagnoses are exclusive to transgender individuals, so any use of logic would conclude this is about sex.
In another bad ruling, the Court said that parents have the right to opt-out of “public school instruction that conflicts with sincerely held religious beliefs.” The case centered on storybooks for young students about gay and lesbian characters. To be clear, gay and lesbian characters weren’t having gay and lesbian sex in the books, they were doing things like existing and getting married. Alito said parents didn’t have to stand for a book that had such a “specific, if subtle, message" about gay marriage that is "contrary to the religious principles that the parents in this case wish to instill in their children." Like the principles of human decency, perhaps?
Finally, the court upheld age verification requirements for porn sites. Texas is one of 19 states that have passed laws requiring every user of adult sites to first provide proof that they are at least 18 years old. This isn’t as simple as clicking the “I am not a robot box” or identifying all of the pictures with fire hydrants. This involves uploading government-issued identification. As in, “Hi my name is Englebert Johnson. I live at 1234 Elmwood Avenue in Dallas, Texas. I’m 5’9” and have brown hair and green eyes. I’m an organ donor, and I’m about to jerk off.”
Free speech advocates argued the law was vague and put too much of a burden on adults before they could carry out their constitutionally protected right to watch step siblings go at it. The Court sided with Texas’s morality police because “what about the children, won’t anyone think of the children.” Yes, won’t anyone think of the children who are likely far more capable of getting around such software impediments than their technology-challenged parents.
Don’t get me wrong, I want young people to watch less porn and am well aware that there’s a lot of terrible porn out there that no teen should watch. We need to educate all teens about porn as part of good sex ed. But I see these laws and this case for what they are, the next step in a campaign to censor porn for everyone. Anthony Comstock would be so pleased.
SCOTUS did make one ruling last week that can be considered a victory. It upheld the preventative care mandate in the Affordable Care Act. The lower court’s decision to strike down the mandate was made by Matthew Kacsmaryk who also ruled against contraception for minors and mifepristone for anyone. Kacsmaryk, a known conservative hack, agreed with a random orthodontist that he shouldn’t have to pay insurance to cover preventative care that he doesn’t need or agree with like contraception (his wife is too old) or PrEP (gay sex and IV drug use are against his religion). Kacsmaryk basically ruled that since this guy didn’t want to pay for it, the rest of us couldn’t have it. Thankfully, SCOTUS did not agree because that decision would have gutted efforts to keep people healthy.
Oh wait.
As I was writing this, Senate Republicans managed to pass their garbage bill that will obliterate the nation’s safety net, put tons of money into the pockets of people who already have tons of money, and add trillions to the deficit (because, you know, they’re the party of fiscal responsibility). It will be weeks of reconciling this with the House version but it’s clear that when it’s all signed fewer people will have access to health care and food. People will die. (But maybe not in Alaska since Lisa got them a deal.)
But when we bury them, they’ll be wearing shiny new Fitbits or Apple Watches because RFK, Jr. swears this is what’s going to make us all healthy again. Actually, they probably won’t have a wearable device because Junior didn’t say that he’d buy them for all of us, just that he planned to spend $20 million dollars telling us how important they are along with clean eating and spiritual growth. Kennedy is particularly enamored with continual glucose monitors (CGMs) like the ones that MAHA Gwyneth (Surgeon General nominee Casey Means) profits off of. CGMs can be life saving for people with diabetes, but there’s no proof that they help anyone else. Blood sugar is supposed to fluctuate throughout the day, and experts agree that there’s no need for most of us to know that it was higher at 3:11 than it was at 4:52.
Trackables play right into the MAHA vision of health as a problem of personal responsibility. These privileged jerks believe that all health problems are a result of poor choices and that if you’re unhealthy, it’s your own damn fault. This warped view totally ignores years of research on the social determinates of health. Health doesn’t exist solely within your body. Instead, things like safe housing, unpolluted water, and education play a role. To steal an example from Healthy People 2030 (a plan from bygone eras when our government gave a s**t about us):
“… people who don't have access to grocery stores with healthy foods are less likely to have good nutrition. That raises their risk of health conditions like heart disease, diabetes, and obesity — and even lowers life expectancy relative to people who do have access to healthy foods.”
In other words, it doesn’t matter what the CGM says. If the only place to shop in your neighborhood is Dollar General and you don’t have enough money to both eat and pay rent, you’re going to eat a lot of processed foods. The unmitigated gall to suggest that wearables and an ad campaign will help while at the same time slashing programs that actually feed people (like SNAP, WIC, and school lunches) could only come from a trust fund baby who doesn’t get it and really doesn’t care. Clearly if you’re fat or diabetic or have high blood pressure, it’s your own damn fault. As a friend of mine said, “Do those wearables come with bootstraps?”
Kennedy also convened his new vaccine advisory council made up primarily of people who have spent their careers undermining vaccines. Their big move was to say they’d only recommend flu vaccines that don’t contain thimerosal. Vaccines are sometimes packaged and distributed in multidose bottles. Thimerosal is a preservative that has been used since the 1930s to keep those bottles fresh and free of contamination. Anti-vaxxers are convinced that this ingredient was one of the reasons vaccines caused autism. That argument is wrong on two level—vaccines don’t cause autism and most of today’s vaccines don’t include thimerosal.
This decision is pretty much meaningless because, and I repeat, most vaccines don’t include thimerosal. This won’t change distribution of flu vaccines. But what it does do is reinforce the notion that our government’s best experts (ha!) worry about the connection between vaccines and autism. It also proves early on that this new vaccine council is going to do Kennedy’s bidding. (In one piece of what constitutes good news these days, an outside group of experts is forming to make actual science-based vaccine recommendations).
Also in Kennedy’s vast department that he’s uniquely unqualified to run, the CDC fired the people who create guidelines for prescribing contraception to women with underlying conditions like heart disease, lupus, or sickle cell disease. Clinicians say that prescribing contraception to healthy women is easy, but they rely heavily on these guidelines for their patients who have more complicated medical histories. I spoke with an OB/GYN the other day who told me that the app this group was responsible for continually updating was the one she referenced most in any given week. (I guess we need a private group for this now too.)
Speaking of outside groups that influence reproductive health, I have one more story to add to the pathetic-that-it-needs-to-be-done-but-good-that-someone-is-thinking-about-it file. On June 9, the American Medical Association (AMA) adopted an official position recommending that medical certification exams be moved out of states with restrictive abortion policies or made virtual.
This came after 20 attorneys general from Democratic states petitioned the American Board of Obstetrics and Gynecology to move its certification exams from Dallas, TX. As of now, you need to take the test in person in Texas to become (and remain) a board certified OBGYN. Some doctors who provide abortions or gender affirming care are understandably afraid to set foot in Texas where what they do is considered felonious and the AG sees few limits to his power. In February, the Lone Star State fined a New York doctor for providing mifepristone to a minor. There’s not much the state can do to her while she’s in New York, but I’m guessing she’s not planning to vacation in Galveston anytime soon.
So far, the board has not backed down from saying the test has to be given in person in Dallas (where it just completed construction on a new building). But doctors hope having the AMA and almost half of the nation’s attorneys general on board will spur action.
I wish I’d had better news to write about. After he edited this issue my husband said, “It’s great. Now I’m depressed, but it’s great.” I apologize to him and to any of you who had a similar reaction to this round up. Maybe go back and read or reread Things We Voluntarily Stuck Up Our Asses for a much-needed break from politics and poor health (or is it the politics of poor health).
Or you could watch this video which always makes me laugh. Always.
Anyone want to share a meme or a video that always makes you laugh? Put them in the comments. We could all use it.
*I’m thinking more Bananarama here than Taylor Swift.
** But this one is dedicated to TayTay