Saturday, August 6, 2011

Online Course: Sociology of Human Sexuality Part 3

cross posted from my Media Justice column

This is a series of posts from the sexuality course I am teaching this summer. Check out thefirst week and second week of notes. If you are interested in receiving some of the readings, syllabus, and workbook assignments please leave a comment with a way to contact you!

Day 6
Abortion, Adoption & Female Sexual Dysfunction

The first part of this class we discussed abortion. In this lecture I explained the legal and political history of abortion in the US, what is included in the procedure, and debunking myths regarding the procedure and people who experience this option. Reading's for this part of the course included What Did The Doula Do?, where I share my experiences as a doula and working with people who are having an abortion procedure. Another reading wasAbortion Doesn't Increase Mental Health Risk but Having A Baby Does, which discusses research conducted by people who are parenting and people who have terminated a pregnancy.

Before beginning this lecture I made it clear to students that no part of this lecture is to attempt to convince them or change their own personal belief and value system about abortion. Instead, this segment is set up to provide information on how our society has come to legalize abortion, what that means, includes, how some states have specific regulations that impact accessibility, and what the procedure includes.

First, I asked the group what three options people who are pregnant have and these include: parenting, adoption, and termination. I began with the Supreme Court decision of Roe v. Wade 1973 which legalized abortion in the US. Since this decision, which falls under our right to privacy in the Constitution. This is one reason why they may hear people say that "abortion is our Constitutional right" because it protected by the 14th Amendment. From here, we discussed how individual states have created requirements around accessing abortions by people who need them. We discussed waiting periods, parental consent and/or notification, judicial bypass, and limitations on when terminations can occur.

Waiting periods are not in all states, they are not in NY, but in other states they are and this includes a person who makes a decision to terminate a pregnancy must first wait 24 hours before having the procedure. The rationale for a waiting period is to allow the person the opportunity to consider all of their options regarding their pregnancy. Some folks who do not support the waiting periods argue that they are condescending and assume a person who chooses termination has not considered all of the options, as if choosing termination is an easy decision.

Depending on the individual state and space that provides the procedure a few things may occur to fulfill the waiting period law. A person may have to physically come into the location and receive written information about all of their options (parenting, adoption, and abortion). Another way to receive this information may be watching a film about all three options, or listening to information over the telephone. After being given this information the person may choose to read/listen/view or not, but they will then have to come to the location again the following day if they choose to continue with their termination. I noted how for some folks this is a challenge. One challenge may be taking off work and having to go to the location twice which may mean not getting paid, and potentially losing a job. Another challenge with waiting periods may be transportation and that some folks may need to find (or pay for) transportation that could be a challenge and an additional cost.

Parental consent and/or notification laws are also not in every state. These are often for youth who are under the age of 18 and choosing to terminate. The parental consent laws require a young person to get the consent of their parent to have the termination. This consent can be offered in various ways depending on the state and facility doing the procedure. Some youth may need a notarized form with a parent signature (one is often enough), a parent joining the young person at the facility is also a form of consent (and proving they are the parent of the young person). Some challenges with this law include some young people do not have parents, they may be in the child welfare system living in a group home (a nice way to say orphanage in the US for older youth) and the state is their guardian. In this situation a social worker that works with the young person will work to get this consent. In other instances it may be that the young person was assaulted or raped by a family member and discussing this with a parent is not what the young person believes is best for them. Another example may be that the young person is fearful of being kicked out of their home and thus talking to their parents.

It's important to note that parental consent is different from a young person having an adult in their life they trust and can go to for support and guidance. If a young person finds themselves in a situation where they cannot and do not want to obtain parental consent for whatever reason a judicial bypass is an option. A judicial bypass is when a young person speaks directly to a judge in closed chambers requesting the judge's permission to not obtain parental consent. Sometimes these conversations include a young person explaining to the judge why they cannot talk with or get the consent of their parents, the judge determining if the young person has considered all their options and are making the best decision. If the judicial bypass is offered a young person does not need to obtain parental consent but will take their judicial bypass with them to their appointment. Some challenges to a judicial bypass is that it can be scary to go to court and talk to a judge. It requires time, planning, and transportation. It may also require a judge who is not anti-choice as this may impact their decision making for the young person in need. In addition, judges are mandated reporters, which means if they hear or see something that harms or neglects a child or older person, they must report it. As a result some youth may choose not to obtain a judicial bypass for fear they will be removed from their home and separated from their family for various reasons.

A parental notification is different from parental consent in that a parent is notified of the termination but does not have to consent to it occurring. This may occur as a letter from the location providing the termination, the young person providing this to their parent, a phone call from the location and/or some other form of contact to the parent. Again, parental notification is not in all states. One student in the class offered their experience having an abortion and the notification they had to provide their parent prior to the procedure occurring and what that was like for them. I'm always humbled when a student is comfortable enough to share intimate information with our class because it demonstrates the trust they have with us as a group building and creating knowledge together. I think this student sharing their perspective helped other students understand the topics we were discussing and putting a human and personal story to the discussion.

Finally, states having limits to when terminations occur and vary by state. In NY terminations can occur up to 24 weeks but other states only go up to 12 weeks, others up to 18 weeks, and so forth. If a person is in a state that only offers abortions up to 12 weeks, that person will have to go out of state to one that offers terminations later in the term. This may go back to transportation access, and if the next state has a waiting period or if the person is a minor and there are parental notification and/or consent laws the person must abide by these regardless of where they live.

After having this discussion we moved onto how abortions are provided. In the US terminations occur based on the last normal menstrual period (LMP) and this is how pregnancies are determined. So, if a person had a menstrual cycle where they only spotted and did not have a full normal cycle, that spotting is not considered a normal cycle and chances are that person is at least 4-6 weeks pregnant. The first trimester is considered 0-12 LMP, the second trimester is considered 12-20 LMP and the third is considered 20+. abortion procedures (which some have heard referred to as "partial birth abortion") occur after 24 LMP and are rare.

We discussed medical abortions where medication is administered early in the first trimester (usually 9 LMP, but this is based upon a locations protocol as some may offer this up to 11 LMP) to induce a miscarriage. Prior to this I reminded students that often the body does what is called "spontaneous abortions" and/or miscarriage which is often no fault of the person who was pregnant. Often we do not even know we were pregnant, and this may occur without our knowledge for various reasons which go back to our first lecture.

We discussed reasons why this option is selected by some folks which may include wanting to have a non-invasive experience, people think this procedure is more "natural" for them, and living in a home where their menstrual cycle is monitored and this resembling a cycle. I discussed how the medication stops fetal development and then induces uterine contractions to help dispel the contents of the uterus. This is a procedure that is offered only in the first trimester because the pregnancy must be small enough to be dispelled from the body. Many people may experience cramping with the uterine contractions and may experience something similar to the heaviest day of their cycle when the miscarriage begins. I also shared that for many folks they assume the miscarriage will begin instantly, but it takes several hours for the medication to begin the process and some folks have different times of when their miscarriage begins.

An emergency number for medical questions is offered, some locations provide people with doulas to contact and be with during this time and a follow-up appointment is required after this procedure. During a follow up procedure a sonogram will be done to make sure there is nothing remaining in the uterus from the pregnancy. If there is, another procedure may occur called a D&C (dilation and curettage) to remove the remaining contents of the uterus so no infection occurs. This may be one side effect of the medical procedure: that not all the contents are dispelled and the person may need a D&C.

If a medical procedure is not offered or desired, a surgical procedure is offered. These may include a D&C or utilize a manual vacuum aspirator (MVA), or a vacuum aspirator. The D&C and the MVA are often primarily for first term procedures while the vacuum aspirator is for later term procedures. If a person experiences a miscarriage and goes to the hospital they will most likely have a D&C performed by their doctor. The D&C includes the dilation of the cervix and then a provider gently scraping the inside of the uterus to remove any remaining contents so no infection occurs. A D&C may also be done for other non-pregnancy procedures, such as taking samples of uterine fibroids to check if they are cancerous. The MVA is a hand held device that gently suctions out the contents of the uterus. This device looks like a large syringe and is used by providers who are comfortable with it as it is more gentle, easier to manage for some, and quieter. Because the MVA is hand held it is only used for first trimester. This procedure often takes 10-15 minutes depending on the provider.

The manual vacuum aspirator is a larger device that has a motor that makes some noise when turned on. The device is attached to a long tube and suctioning device that providers insert into the vaginal canal and cervix to remove the contents of the uterus. Depending on how large a pregnancy is and the comfort of the provider, this device may be used. If the person is over 12 LMP this is often the device used. If a person is over 14 LMP they may need a 2-day procedure. The first day a person will have laminar inserted into the cervix. Laminaria is dried algae that when placed on the cervix assists in absorbing the moisture and opening up the cervix. Depending on how large the pregnancy is influences how many laminar are inserted. These laminar are left overnight in the cervix and the second day the procedure occurs. Sometimes a provider may need a 3-day procedure where the first two days are laminar insertion to help expand the cervix. On the second or third day the laminar are removed and the vacuum aspirator is used to remove the contents of the uterus. These procedures usually take about 20-25 minutes depending on the provider.

For late term procedures I shared that there are only two states that provide terminations beyond 24 LMP. One of the two physicians in our country to provide these procedures, Dr. George Tiller, was murdered three years ago by an anti-choice conservative religious fundamentalist and his facility closed. Students asked why this happened and how someone could validate killing an adult if they were anti-choice and not for harming a fetus. They were confused and I reminded them that just because abortion does not exist or is not legal, the need may still remain. People who need procedures often planned to parent, looked forward to being parents, may have already set up a room for their child, bonded with their child, and are devastated because a medical complication has occurred to their child. There could be a fetal anomaly, the child could be in pain, dying, or dead and the pregnant person's life could be in danger. All of these experiences are devastating for parents.

Late term procedures are heartbreaking, expensive, and long. Depending on the situation this may take a one-week period. Often people may have health insurance that will cover the procedure. This procedure includes: having to travel to the state where a physician is located to do the procedure which is in the mid-west, so airfare is one cost, hotel for the duration of the procedure, food during the stay, childcare (if needed) while away, cost for medical procedure and medication, cost for decisions made regarding the body (i.e. paying for coffins, cremation, and having those approved for flight back home). All of these things have a price tag attached to them and thus these are not decisions people come to lightly. Often these locations are partnered with various religious leaders who can provide support and burial services as needed/requested by the family for their child. Sometimes families want to hold their babies and as a result a pregnancy is induced. As we discussed in our pregnancy segment, labor can take days.

Some side effects of abortion include: uterine perforations, which, if they occur, do not occur very often. Seasoned and well-trained doctors rarely experience uterine perforations, which are when the uterus is punctured during the procedure. As we had discussed on the first day of class, the uterus is a very thick and dense muscle and to puncture it takes a lot of force and for some a lack of experience. A uterine perforation can be repaired and if done properly a person can experience a pregnancy again and carry to term.

There is also some bleeding after procedures similar to menstrual bleeding, which may include some clotting that may folks experience when menstruating. Cramping is also normal side effect that physicians recommend ibuprofen (not tylenol which is a blood thinner) to alleviate. Feelings of relief are most commonly reported by patients (relief that the procedure is over, the pregnancy is over, the coping and mourning can occur, etc.) but other emotions are also common and are also based on the individual. Finally, abortion procedures when done by trained physicians are safe, more safe than giving birth, and people can have children in the future.

For our conversation about adoption we discussed the different types of options for adoption. If a pregnant person knows early on they are choosing adoption they may have a say in meeting and choosing the people/person who will adopt their child. Some adoption agencies offer closed adoptions where the person giving birth does not have any contact with the adoptive person/family, they agree to whatever the adoption agency guidelines are about contact and communication and relinquish their parental rights. This may also include having adoption information sealed and only opened by the child that is adopted at a certain age. For the most part a closed adoption means not contact for the pregnant person.

An open adoption I compared to what some folks may have seen on the Teen Mom MTV series. This is where the pregnant person may have an active role in choosing the adoptive parents, have the adoptive parents a part of the pregnancy experience, coordinating visits with them throughout the child's life, and communicating with the adoptive family. There are other types of adoptions where the pregnant parent and the adoptive one work out what is best for them. Often a lawyer is involved and the pregnant person may not have authority or power of attorney over the child, instead the adoptive parent may have those rights and responsibilities.

Female Sexual Dysfunction
Most of our conversation centered on the documentary film Orgasm, Inc. which discusses how the medicalization of female sexual dysfunction (FSD) have been created and if students think FSD really exists. Read my review of the film Orgasm, Inc.
here to see all the topics presented and discussed in this documentary.

Day 7
Reproductive Justice

This class we had a guest speaker who joined us to discuss reproductive justice. Often we hear terms like "reproductive rights" but we are unclear what that includes and means. I invited Aimeé Thorne-Thomson who provided 3 online readings for this session which include: [A New Vision For Advancing Our Movement For Reproductive Health, Reproductive Rights, and Reproductive Justice](],
Understanding The Connections and an MP3 download of Aimeé on a panel called Abortion Apathy? Feminist Bloggers Speak Out About Reproductive Justice (Aimeé's link is thesecond one listed if you'd like to listen).

Prior to Aimeé joining us I gave a brief overview of the Feminist Sex Wars. And by brief, I mean like 15 minutes, which is really only an introduction to the topic. I introduced and defined feminism in the way that bell hooks has in her book Feminism Is For Everybody as a movement to end sexism, sexist oppression for all people. I mentioned that many folks may not agree with this definitions, that at the time the Sex Wars were occurring this may not have been the agreed upon definition. I pulled from our conversations around sexual orientation and gender to connect this piece of history.

At this time many folks who identified as feminist were also speaking on the ways that the US feminist movement was not meeting or including all people. There were some people who identified as radical feminists who believed that any type of consensual sexual relationship with men resulted in oppression and consenting to rape. For this reason some folks chose to partner with other women and identified as lesbians because they believed that was the only form of equal relationships. Lesbians who had been lesbians prior to joining the US women's movement also had some aspects of their lives that were targeted. For example, discussions of "butch" and "femme" identities were challenged by US feminists and believed to be examples of perpetuating patriarchy and thus oppressing women.

A discussion of butch and femme identities and gender expressions connected to help students understand that gender expression is about how we feel most genuine and our true selves and how we share that with the world. I used myself as an example of how I identify as a femme and how that connects to my use of make-up, choice of wearing dresses, having long hair and painted nails (to name a few). Other conversations around pornography were also a zone of contention for US feminists. Some argued from an anti-pornography perspective that believed all forms of pornography were harmful, especially to women. Other folks fell in the middle of the debate where they argued anti-censorship. They did not claim to support or not support pornography, instead argued that they were against censorship. Other folks identified as pro-sex which argued that consenting adults can watch and purchase whatever they choose, did not see pornography as harmful to women who chose to be in pornography, and that women must be supported in all aspects.

When we discuss sex work later this week, this will connect again from these perspectives. Although folks have found themselves in three different camps regarding pornography, similar spaces occur on various topics in sexuality such as comprehensive sexuality education, abortion, sexual orientation, and even FSD.

When Aimeé arrived I shared her bio with students, she was most recently the interim Executive Director of Astrea Lesbian Foundation for Justice prior to that she was the executive director for Pro-Choice Public Education Project (PEP). She started her discussion with giving us a definition of reproductive justice, and she embraces the one by Asian Communities for Reproductive Justice who produced A New Vision For Advancing Our Movement For Reproductive Health, Reproductive Rights, and Reproductive Justice, which published in 2005, was the first paper to ever be published that defined the three terms (reproductive rights, reproductive health, and reproductive justice) differently. ACRJ defines reproductive justice as:

We believe reproductive justice is the complete physical, mental, spiritual, political, economic, and social well-being of women and girls, and will be achieved when women and girls have the economic, social and political power and resources to make healthy decisions about our bodies, sexuality and reproduction for ourselves, our families and our communities in all areas of our lives.

She shared the history of the origin of the term beginning in 1994 by women of Color, especially racially Black women who coined the term to incorporate reproductive rights, social justice and power. Reproductive rights included policies and laws. Folks who work in reproductive rights are often lawyers, lobbyists. Reproductive health is connected to providing services, so folks such as doctors, nurses, physician assistants, doulas, midwives, all fall under reproductive health providers. Reproductive justice is about organizing and movement to transform society.

Below is a video of Loretta Ross, cofounder and national coordinator for Sister Song, Women of Color Reproductive Justice Collective, speaking on the reproductive justice framework:

Aimeé shared that reproductive rights organizations may include NARAL and Planned Parenthood; reproductive health include centers such as Planned Parenthood that provide care, but also think tanks that do research and provide data such as the Guttmacher Institute; reproductive justice organizations include Sister Song, ACRJ and youth led organizations. All three terms overlap but they are NOT the same. Using them interchangeably is not correct. Yet, the all work together to create change and when this occurs resources can be shared. However, not everyone "plays nice" as Aimeé shared.

These people are and in leadership positions and important parts of the movement and mobilizing. Some key elements of reproductive justice include:

  1. 1. Transforming power: creating change at every level: communal, societal, state and local level.
  2. 2. Intersectional analysis: all identities and things in society build and work together so all the aspects and pieces are recognized.
  3. 3. Controlling bodies: how people identify based on gender, parenting, expressing their sexuality and how we are able to control and make decisions for ourselves.
  4. 4. Most impacted people call the shots: they are the primary leaders in how to move forward because they live the lives that are being impacted.

Aimeé then shared some ways that students can get involved with reproductive justice. These included:

  1. 1. The National Latina Institute for Reproductive Health has scheduled this week (August 1-5, 2011) as the Latina Week of Action for Reproductive Justice where they are focusing on immigrant women and how they are scapegoats for various things in our society. They are asking for folks to write their personal stories on the topic and share them.
  2. 2. The Doula Project, located in NYC, provides support and emotional encouragement for pregnant people at all spectrums of pregnancy.
  3. 3. Sister Song has an NYC chapter (and others around the US if you are reading and are outside of NYC) they organize events, film screenings and fundraising events.
  4. 4. Choice USA provides trainings, leadership development and organizing.
  5. 5. Advocates for Youth and Amplify Your Voice (yay!)
  6. 6. Asian Communities for Reproductive Justice 10 year national initiative to change the ways people see and understand families in the US. This project is called Strong Families where folks can share their Strong Families story and read others.

Additional ways to get involved that are not attached to large organizations include:

  1. 1. Voting and if you can't vote, you probably know others who can
  2. 2. Educate yourself through reading, online communities, and blogging
  3. 3. Volunteer working by providing time, skills, money, and building connections and networking are central to reproductive justice
  4. 4. Contact your representatives and tell them what YOU want and how you want them to represent you.
  5. 5. Do it yourself! If there is an issue, topic, experience that is not being representing, make your own organization and find members and mentors!
  6. 6. Post to Facebook and share topics that impact reproductive justice with those people in your network.
  7. 7. Use Twitter and join in on the conversation occurring around reproductive justice.

She then opened it up for conversation and questions. She was asked what at typical day looked like for her, how did she come to do this work, and what does being an ally look like for her? She shared that a typical day is non-existent and often each day is different. However, there is a lot of strategizing. She did not imagine her work being in reproductive justice when she was in college at Yale, or really it applying when in graduate school. It was something she came up on while working in various fields and learning about herself. When asked about being an ally she shared that when she was at the Astrea Foundation she realized that she came in as an ally because she identifies as heterosexual. She made the point that there is a power dynamic for allies to recognize that sometimes their work is to sit quietly and listen, that people will have different perspectives because they are members of the community. She also discussed how to strategically use her power and privilege to lift a particular issue and topic further, to ask more questions about what her colleagues need.

Day 8
Love & Relationships

This segment focused on the first chapter of bell hooks book
All About Love: New Visions as well as the video Origin of Love, a song from the film Hedwig And The Angry Inch. See the video below:

This was one of the most lively conversations we've had in class so this segment may be a bit short as there was lots of discussion! As we began, I first offered some background history on who bell hooks is and what she represents. I mentioned that she identifies as a Black woman, a feminist, and some consider her a public intellectual because she has published so many books on various topics from feminisms, media, race, and love.

I asked them what they remember about bell hooks from the chapter we read and they mentioned how she shared that she came from a dysfunctional family. I asked them how they understood her family to be dysfunction from her explanation and they shared her describing her experiences as being in a family that only offered care, not love. Some students disliked her defining her family as dysfunctional. Their argument was that she's comparing her family to a societal norm, which does not change anything but label more families dysfunctional.

I went on a short tangent and spoke about how Daniel Patrick Moynihan had written The Negro Family: The Case for National Action, which was one of the documents that harmed Black families all over the US because it stated that Black families were perpetuating poverty because of there not being two-parent (heterosexual) families like in racially white families. It also made connections to welfare programs and economic challenges for Black families. What the documents did not do is ask Black families what they needed, what could help them with their daily needs, what changes they think need to be made. To this day, scholars and activists are working to challenge this document as it has saturated so much of what people think they know about Black families.

Another document that had a similar response was Oscar Lewis' La Vida and how his focus on the "culture of poverty" he assigned to working poor families and communities of Color (especially Latinos) is still present today. The idea that Latinos value poverty and that is why they remain there, is very similar to what the Moynihan report did to Black families. This is some of the historical legacy that leads us to understanding how a dysfunctional family is defined.

I wrote hook's definition of love on the board which includes:

"To truly love we must learn to mix various ingredients—care, affection, recognition, respect, commitment, and trust, as well as honest and open communication."

Several students did not agree with this definition. One of the main reasons to resist this definition were because, as they argued, everyone may define the terms care, affection, recognition, respect, commitment, trust, and honesty differently. I asked if they agreed with bell hooks who stated that "[i]f our society had a commonly held understanding of the meaning of love, the act of loving would not be so mystifying." Some folks agreed others did not.

I asked if there were different types of love and the class agreed. We came up with a list of different types of love which included: familial, parental/motherly, friendship, self, agape, eros, and sexual. I asked if they agreed with bell hooks when she wrote "love and abuse cannot coexist." They asked why hooks did not define abuse as she had defined love and what does that mean for the reader and defining abuse. We had a great conversation about abusive relationships, what love looks like when there are levels of violence, if it is really love, why not, how can it be, and so forth. We even spoke about spanking and how that may be seen as a form of abuse from an outsiders perspective. Some parents in the class shared their views on disciplining their children. I then asked them what their own definitions of love were and they ranged from the following:

"growth, emotional, strength, honesty"
"unconditional, comfortable like friends, and being able to pass gas in front of the other person"
"take a bullet for someone"

It was such an amazing conversation to be able to facilitate and be a part of. This is one of the reasons why I adore teaching, to have this level of engagement and discussion among amazing young scholars. It is such a privilege to be in those spaces, it gives me new energy!

To end the class, I asked them to each write themselves a love letter on campus letterhead and then write the address they want the letter to go to on the envelope provided. I told them I'll mail them these letters sometime in the fall semester. It was great to have an in-class writing assignment where we all sat quietly for several minutes thinking about the love we have for ourselves and how we will be reminded of this day in months to come.

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