The XX Factor: What women really think.

What Aretha Franklin Can Teach Your Teen Boys About Sex

The New York Times health section must have been reading my mind: They answered the question I asked last week, "Is the Teen Sex Talk Different for Sons and Daughters?" with an article and a blog post today. According to pediatrician Perri Klass, M.D., the way you should talk to your adolescent sons about sex is both the same and different from the way you might speak to your daughters. While it's important to teach both boys and girls basic tenets of politeness, Klass writes that, as a pediatrician and a mother of boys, "I acknowledge that for their own protection, boys need to understand that there are people—male and female—who will see them as potential predators, and judge them automatically at fault in any ambiguous situation."

However, Klass notes that a little respect (as Aretha says) goes a long way. Klass quotes Dr. Lee M. Sanders, another pediatrician who takes care of teen boys, about how he approaches the subject of sex: "We’ll talk about respect, about whether they feel they are respected in their own families, the respect they have for their mothers, the respect they see other men paying to their own mothers or sisters—do you think that applies to other girls that you meet?"

Tara Parker-Pope's related blog post opens up the question to commenters, and in the peanut gallery Alex Lickerman, M.D., argues, "If the adults participating in the conversation are comfortable talking about sex, the child will be as well. We’re the ones who make children nervous about this topic. Before having this discussion maybe we should examine just how comfortable we are or aren’t with our own sexuality." As someone who was a teen not so long ago, I disagree with Lickerman—my parents weren't awkward when talking to me about sex at all, and yet I was still mortified—but I want to hear from the moms out there, especially the moms of sons: Do you speak to your sons and daughters differently about these issues?
 

Did Socialized Medicine Kill Natasha Richardson?

Has anybody else been picking up on the effort to create a comparative health care storyline out of the Natasha Richardson tragedy? A friend mentioned a couple of days ago that she wondered if Richardson's death from "talk and die" syndrome would have been prevented had she fallen sick in the United States, and then today, this PR e-mail from a think tank that promotes health savings accounts arrived in my inbox:

NEWS REPORTS REVEAL NATASHA RICHARDSON’S DEATH MAY HAVE BEEN PREVENTED WITH U.S. HEALTHCARE

Lack of Equipment Under Government-Run System Delayed Lifesaving Measures

Washington, DC – News reports of the skiing accident, medical treatment and eventual death of actress Natasha Richardson last week shed new light on the limits of the Canadian health care. The timeline of the afternoon’s events indicate that the lack of medical equipment—a trauma helicopter and basic CT scanning equipment at the local hospital—delayed the treatment that may have saved her life.

Well, it's certainly possible. But I'd hope the Natasha Richardson Proof—the Canadian health care system didn't work perfectly for Richardson, ergo it sucks—doesn't become some major PR tactic during a health care debate, because it's a serious case of missing the forest for one tree.

A trauma helicopter might have helped Richardson, but on the flip side, in the United States such helicopters are generally way overused, in part because they're profit makers and because the burden of their costs is distributed in such a way that it isn't appropriately felt: This past September, a Medevac chopper crashed in Maryland, killing three personnel (including one ambulance volunteer, a gig I've done) and one of the two wounded girls it was transporting from the scene of a car crash. Both girls originally had non-life-threatening injuries. "We've just gotten into a situation here in the United States where we think that the helicopters are a panacea," an emergency medicine researcher told the press after the accident. The September crash, sort of the reverse image of the Richardson incident, could be considered an event in which the overabundance of medical equipment killed.

Everything You Need To Know About Marriage

These few words from a BBC News story speak volumes:

US psychologists found wives in tense marriages were prone to risk factors for heart disease, stroke and diabetes. In comparison, husbands seemed relatively immune from such problems.

Heart disease, of course, is the No. 1 killer of women. The AHA counsels prevention through exercise and good nutrition, and, now, divorce. Not really, of course, but this suggests that beneath all those TV sitcoms on which the wife looks fit and healthy and the husband seems fat and winded lurks a murkier truth.

Rule Britannia

According to an article published in the London Times today, we Brits are now the most promiscuous nation in the world (of the western industrial nations, that is). In terms of one-night stands, total number of partners, and our "relaxed" attitude to casual sex, we beat Australia, the United States, Italy, and France. France! Where having extra-marital affairs is a favorite national pastime! If nothing else, at least now we might lose our reputation for being frigid and repressed.

In all seriousness though, Britain has the highest teen pregnancy rate in Europe as well as the highest teen STD infection rate in Europe (although both are significantly lower than here in the United States, where abstinence-only sex education doesn't seem to be helping much). Premature sex education in British schools (it can be taught to children as young as 4) has long been blamed for the epidemic, along with the inappropriate sexualization of children by toy manufacturers and the media. But here's a thought. In Britain, we also drink more than any other country in Europe (apart from Ireland and Finland, bizarrely), and our alcohol-related death rate has doubled since 1991. We've also, according to this reasonably insulting story in the New York Times, been causing havoc on summer vacations with our abhorrent, booze-soaked behavior. Could there be a correlation somewhere between the beer goggles and the newfound sluttiness?

The Marriage of Love and Politics

Three cheers for Stephanie Coontz's piece in the New York Times today in defense of taking marriage private. She asks:

Why do people—gay or straight—need the state’s permission to marry? For most of Western history, they didn’t, because marriage was a private contract between two families. The parents’ agreement to the match, not the approval of church or state, was what confirmed its validity.

She offers a persuasive case that in today's climate—with divorce rates still high—we need to rethink the state's involvement in marriage. And she points out the logical peculiarity of the fact that unmarried couples who've cohabited for 19 years might have no hospital visitation rights—while two kids who get married on a whim automatically do.

These are all questions I've had on my mind, because I got married this summer after a six-year relationship. I’m happy to be married—in fact, this week, I’m particularly glad, because I’m scheduled to have surgery, and if I weren't married, my partner might have met with far more resistance from Oxford Health Plans when he called on my behalf to investigate the fine points of the claims process. Being able to say the words my husband to doctors and nurses has made bureaucratic matters far easier to manage than the words my boyfriend ever did. One reason is obviously that in an era of constantly shifting relationships, the government and hospitals need some way of figuring out how to distinguish the loose bonds of a one-night stand from the deeper ties of a long-term relationship. But at this point in time marriage doesn't seem to perform that function as well as it might. For one thing, it's the policization of marriage that gives some young couples pause about wedlock. Not to get all Brad-and-Angelina about it, but for years I didn’t want to get married because I didn’t want to participate in an institution that was closed (or largely closed) to my gay friends and family members. Clearly my resolve weakened since then, but it still bothers me that I'm part of something that is not aavailable to all my peers.

So, I'm glad pieces like Coontz’s—which get fresh conversations started—are part of the debate about how modern matrimony might provide the greatest good to the most people, children and adults alike.  

Breasts, etc.

Rachael, isn’t part of the issue that white-collar jobs tend to accommodate pumping and breastfeeding more than blue-collar or service industry jobs do? This piece, for instance, paints a stark contrast between female Starbucks execs who get to use a lovely “Lactation Room,” and women working behind café counters who have to pump in bathrooms during quickie breaks. Anything that makes it easier for women to pump at work (or during their medical boards!) seems like a good idea to me – and not paternalistic.

Meanwhile, speaking of Emily’s great piece, I wanted to mention another mind-bending example of how environment can influence gene expression. This one comes from a UC Davis psychologist named Brian Trainor, who’s done fascinating work on the relationship between estrogen and aggressive behavior in mice. Last year, Trainor found that estrogen can have completely opposite effects on aggression depending on the length of daylight. Specifically, the hormone made mice less aggressive when daylight hours were kept long, simulating summer. But it made them more aggressive when daylight hours were short, simulating winter. (The pathways involved were probably different, too.) No one knows whether similar effects will be found in humans. But isn’t it wild to imagine estrogen making us docile in summer and assertive in winter, too? 

More on Teen Sex

If early sex isn't necessarily bad sex, could we agree that it's usually a bad idea? I'm agnostic about calling parents, because it seems so case by case to me, in terms of the kids and the parental relationships involved. And I'm all for the release of a 17-year-old like Genarlow Wilson, whose case exemplifies the worst intersection of adult prudishness and prurience. I also remember from my middle school years a couple of cases of kids having sex at 13 or 14 that didn't seem harmful. But I also remember other kids who seemed confused or taken advantage of, and yes, they were girls. Juliet, do we really want to veer closer toward a norm that sweeps up young teens? You were in 8th grade a lot more recently than I was--what in your experience makes you think differently than I do?

Don't call the cops, but do call the parents...

Torie, I agree that there’s no need to call the D.A.’s office on teenagers messing around, but I do think the parents of middle schoolers have a right to know the score, so to speak. I don’t what’s up in Portland, Maine, but they seem to be having trouble locating the vast expanse of middle ground between initially refusing to let the parents of 11-year-olds know they were handing them birth control – and now promising that they will report every sexually active kid to the cops.

Has anybody else seen that Disney movie where Goofy follows his son off to college because he misses him so much?  That is going to be me in a few years, moving in across the street from West Point, just like Douglas MacArthur’s mommy. As a warm-up, a couple of summers ago, I had the bright idea that I would accompany my children to a camp for 9- to 18-year-olds, where I would teach a little writing class and get loads of work done.

One of the reasons that loads of work thing didn’t happen is that I had other duties at this camp, too – patrolling the rec center to bust up late-night make-out sessions, for instance. Some of the other teachers were assigned an even more onerous job, on a detail known as the Bush Patrol. (My then-9-year-old son was happy to hear that the staff was on the lookout, making sure the president was nowhere in evidence.) But no, what this assignment really involved was whizzing around the far reaches of the campus in a golf cart, armed with a whistle and flashlight, interrupting couples at play in the bushes. If you broke up anything serious, you were supposed to call the parents and report exactly what you had seen.

I swore I would never do anything of the sort, but some of my friends felt otherwise, and one said she already had made such a call -- and had even provided details when the dad on the other end of the line refused to believe her: “Sorry, sir, but your daughter’s head was moving up and down.’’

Bad as it was for this friend who had to make that call, getting it must have been many times worse. Yet still not as bad as not getting it might have been, you know? There is just too much at stake to keep parents of the loop.

Re: Re: Birth Control for Middle-Schoolers?

Alas, Dahlia, if you’re looking for a good argument for allowing condoms and not prescription birth control, I’m bound to disappoint. I somehow missed the info that the district has been passing out condoms for so long. At the risk of sounding like a fuddy-duddy (but to avoid being sexist) allow me to clarify: I’m not in favor of ANY school-sponsored birth control for 10- or 11-year-olds, for either boys or girls. Schools should not be condoning sex between middle-schoolers. Here’s a question: If a 12-year-old gets a prescription for the pill so she can have sex with her 17-year-old boyfriend, is the school contributing to statutory rape? And the flip side: If a school-provided condom breaks and a 12-year-old boy gets his girlfriend pregnant, is the school responsible? I smell lawsuit …

In Other Depressing News, Women's Health

The National Women’s Law Center and the Oregon Health & Science University released a truly grim report on Wednesday. Women’s health care in the U.S. is unsatisfactory overall, and no state earned a “satisfactory” grade for women’s health.

The two groups measured women’s health in all 50 states and D.C. by using 27 benchmarks (ranging from rates of obesity to routine breast cancer screening) designated by the Department of Health and Human Services’ Healthy People 2010 campaign. Only three of the benchmarks were met – women receiving regular dental, colorectal cancer screening for women over 50, and the percentage of women 40 and older getting mammograms. Among the 24 unmet goals: rates of obesity and diabetes are way up. In Mississippi (which was ranked last for women’s health overall), the report states that 31.5 percent of women are obese.

It's also discouraging that results varied significantly by race. The report found that 85.7 percent of white women received prenatal care, compared with 75.9 percent of blacks.

RE: Birth control for middle-schoolers? And The “Feminist Project”

Rachael, your post on the decision of a Portland, Maine, middle school to allow students to get prescription birth control without parental notification was prescient. Everyone’s gone bonkers toady and O’Reilly is hardly even the most unhinged. (Best line from O’Reilly’s post today “It is ironic that the week my book "Cultural Warrior" comes out in paperback, intense culture battles erupt across the country.”) Imagine, Bill’s book comes out in paperback and culture battles happen in America!!!

I agree with you Rachael that there is something ick-inducing about giving birth control pill to 10-year-olds. But I am still not hearing any good argument for how this differs from handing out condoms – something the school had been doing for eight years. Is it the difference between providing birth control to girls instead of boys? Is it O’Reilly’s distinction that condoms prevent disease whereas pills prevent “only” pregnancy? Or is there something about offering someone else’s child a pill that makes the Portland scheme more intrusive?

Largely agree with Anne and Ms. Thatcher, but a quick note on yesterday’s blog criticism: It’s bizarre to me to hear that Slate is somehow better for the “Feminist Project” without a women’s blog than with it. It’s even harder to fathom how our women writers are better “feminists” if they avoid discussing women’s issues. Is this some new half-starved Beverly Hills feminism: Do everything you can to present yourself as less of a person than you actually are?

Birth control for middle-schoolers?

Soon after reading Amanda’s post on Susan Orr’s appointment to head the Office of Population Affairs—the office in the Health and Human Services Department that oversees family planning—I read that the school board in Portland, Maine, has—by an astounding (to me) 10-2 vote—decided to allow middle-students to get prescription birth control without parental notification.

 Putting the two stories alongside each other demonstrates what a disheartening divide we still have on the topic of birth control, without even bringing up abortion. I might be the only person writing here who wishes abortion weren’t legal, but I’m a pragmatic pro-lifer: Birth control is a wonderful thing. Condoms, the pill, sponges—the more, the better. It’s beyond ridiculous to tell women that they shouldn’t have abortions and then oppose any means by which they can prevent pregnancy.

 At least, I like to think I’m pragmatic on this issue. But when I read that people want to put 12-year-old girls on the pill and not notify parents, I’m horrified. Sure, you can throw up your hands and say, “They’re having sex anyway. Shouldn’t we do what we can?” But once you do that, where do you draw the line? Is there even a line left to draw? William Saletan had an interesting piece a few weeks ago that discussed how difficult it is to come up with an appropriate “age of consent.”  One line from that piece (and I’m not trying to take Will out of context—his article dealt largely with statutory rape) seems relevant to this discussion:  “Consent implies competence, and 12-year-olds don't really have that.”

 I know the statistics show that offering birth control to teenagers doesn’t increase sexual activity. But so many people—parents, educators, volunteers—are working hard to help girls create build self-esteem and create the positive self-images that encourage them to say no to sex. Measures like this one seem to undercut those efforts. And isn’t one of the problems with education today that parents aren’t involved enough? By removing the parents from the equation here, you’re not doing anything to foster the strong family relationships that our children need.

 (As an aside, I also find it odd that some schools have such a zero-tolerance policy for drugs that they will suspend a girl for taking a Motrin for PMS; yet in other places schools will help girls get the pill.)

 After all that, I guess my question is this: Will we ever reach a middle ground, where we can  agree that it’s stupid to say “abstinence rules,” yet still think it’s a pretty damn bad idea to give 12-year-olds the pill behind their parents’ back?

In Other XX News

The beleaguered federal office that oversees family planning services just got another boss hostile to birth control.

Among the depressing details: Susan Orr, the new appointee, was formerly a Senior Director at the Family Research Council, a group that disparages condom use and claims that abstinence is the only healthy choice to make about sex prior to marriage. In 2001, when the Bush administration wanted to stop requiring health plans for federal employees to pay for a broad range of contraceptives, Orr told the Washington Post: “We’re quite pleased because fertility is not a disease. It’s not a medical necessity that you have it.”

Orr is not as floridly insane as Eric Keroack, whom the Bush administration appointed in 2006 to head the same office (and who left in March to address allegations against his private practice.). Keroack championed the bizarre idea that premarital sex wreaks havoc on brain chemistry, creating a physiological barrier to love and commitment later on. Orr won’t inspire mocking editorials long after her appointment. She’s likely to slip from public view. Which to me makes her a whole lot scarier.