Two Articles, One About Abortion and One About Women, Gender, Sexuality and Medicine

First, from The New York Times, The New Abor­tion Providers:

[After Roe vs. Wade,] the clin­ics also truly came to stand alone. In 1973, hos­pi­tals made up 80 per­cent of the country’s abor­tion facil­i­ties. By 1981, how­ever, clin­ics out­num­bered hos­pi­tals, and 15 years later, 90 per­cent of the abor­tions in the U.S. were per­formed at clin­ics. The Amer­i­can Med­ical Asso­ci­a­tion did not main­tain stan­dards of care for the pro­ce­dure. Hos­pi­tals didn’t shel­ter them in their wings. Being a pro-choice doc­tor came to mean refer­ring your patients to a clinic rather than doing abor­tions in your own office.

This was never the fem­i­nist plan. “The clin­ics’ founders didn’t intend them to become vir­tu­ally the only set­tings for abor­tion ser­vices in many com­mu­ni­ties,” says Car­ole Joffe, a soci­ol­o­gist and author of a his­tory of the era, “Doc­tors of Con­science,” and a new book, “Dis­patches From the Abor­tion Wars.” When the clin­ics became the only place in town to have an abor­tion, they became an easy mark for extrem­ists. As Joffe told me, “The vio­lence was pos­si­ble because the rela­tion­ship of med­i­cine to abor­tion was already ten­u­ous.” The med­ical pro­fes­sion rein­forced the out­sider sta­tus of the clin­ics by not speak­ing out strongly after the first attacks. As abor­tion moved to the mar­gins of med­ical prac­tice, it also dis­ap­peared from res­i­dency pro­grams that pro­duced new doc­tors. In 1995, the num­ber of OB-GYN res­i­den­cies offer­ing abor­tion train­ing fell to a low of 12 percent.

“Under pres­sure and stigma, more doc­tors shun abor­tion,” wrote David Grimes, a lead­ing researcher and abor­tion provider of 38 years, in a widely cited 1992 med­ical jour­nal arti­cle called “Clin­i­cians Who Pro­vide Abor­tions: The Thin­ning Ranks.” In a 1992 sur­vey of OB-GYNs, 59 per­cent of those age 65 and older said that they per­formed abor­tions, com­pared with 28 per­cent of those age 50 and younger. The National Abor­tion Fed­er­a­tion started warn­ing about “the gray­ing of the abor­tion provider.” In the decade after Roe, the num­ber of sites pro­vid­ing abor­tion across the coun­try almost dou­bled from about 1,500 to more than 2,900, accord­ing to the Gutt­macher Insti­tute. But by 2000 the num­ber shrank back to about 1,800 — a decline of 37 per­cent from 1982.

There’s another side of the story, how­ever — a delib­er­ate and con­certed coun­terof­fen­sive that has gone largely unre­marked. Over the last decade, abortion-rights advo­cates have qui­etly worked to reverse the mar­gin­al­iza­tion encour­aged by activists like Ran­dall Terry. Abortion-rights pro­po­nents are fight­ing back on pre­cisely the same turf that Terry demar­cated: the place of abor­tion within main­stream med­i­cine. This abortion-rights cam­paign, led by physi­cians them­selves, is try­ing to recast doc­tors, chang­ing them from a weak link of abor­tion to a strong one. Its lead­ers have built res­i­dency pro­grams and fel­low­ships at uni­ver­sity hos­pi­tals, with the hope that, even­tu­ally, more and more doc­tors will use their train­ing to bring abor­tion into their prac­tices. The bold idea at the heart of this effort is to inte­grate abor­tion so that it’s a seam­less part of health care for women — embraced rather than shunned.

Sec­ond, from Newsweek​.com, The Anti-Lesbian Drug:

Genetic engi­neers, move over: the lat­est scheme for cre­at­ing chil­dren to a parent’s spec­i­fi­ca­tions requires no DNA tin­ker­ing, but merely giv­ing mom a steroid while she’s preg­nant, and presto — no chance that her daugh­ters will be les­bians or (worse?) ‘uppity.’

Or so one might guess from the storm brew­ing over the pre­na­tal use of that steroid, called dex­am­etha­sone. In Feb­ru­ary, bioethi­cist Alice Dreger of North­west­ern Uni­ver­sity and two col­leagues blew the whis­tle on the con­tro­ver­sial prac­tice of giv­ing preg­nant women dex­am­etha­sone to keep the female fetuses they are car­ry­ing from devel­op­ing ambigu­ous gen­i­talia. (That can hap­pen to girls who have con­gen­i­tal adrenal hyper­pla­sia (CAH), a genetic dis­or­der in which unusu­ally high pre­na­tal expo­sure to mas­culin­iz­ing hor­mones called andro­gens can cause girls to develop a deep voice, facial hair, and masculine-looking gen­i­talia.) The response Dreger got from physi­cians and sci­en­tists who were out­raged over this unap­proved use of dex­am­etha­sone caused her to dig deeper into the sci­en­tific papers of the researcher who has pro­moted it.

Dreger is one of the women who brought the cli­toral surg­eries per­formed by Dr. Dix Pop­pas to light.

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