What Women Really Think

July 22 2014 3:14 PM

$190 Million Can’t Buy “Closure” for the Victims of Johns Hopkins’ Abusive Gynecologist

For 25 years, Dr. Nikita Levy ran an obstetrics and gynecology practice out of the East Baltimore Medical Center, a community clinic run by the Johns Hopkins Hospital and Health System. Last February, Johns Hopkins authorities discovered that Levy had been secretly filming his patients in the examination room, using cameras embedded into pens that he wore around his neck and key fobs he carried in his pockets. At his home, police found hard drives and servers stocked with thousands of videos and photographs of his patient’s naked bodies, snapped under the auspices of performing routine pelvic examinations.

Levy treated 12,600 patients during his 25-year career. They will never know whether their trusted gynecologist filmed them at their most vulnerable: The evidence, collected by police, doesn’t reveal their faces, and Levy killed himself shortly after his abuse was discovered. Some patients now say they recall Levy bringing them in for unnecessary treatments and touching them inappropriately under the guise of medical care. In a lawsuit filed last fall, one former patient wrote that she and other victims must now live with the fact that their doctor viewed them “not through the clear eyes of a physician but through the filthy lens of a depraved pervert.” Some say they no longer feel safe seeking medical care at all. Others feel uncomfortable even bringing their children to doctors.

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“They are in fear, dismayed, angry, and anxious over a breach of faith, a breach of trust, a betrayal on the part of the medical system,” Jonathan Schochor, an attorney who represented 8,000 plaintiffs in a class-action suit brought against Johns Hopkins’ medical network, said in a news conference Monday. “Many of our clients still feel betrayed, and still feel the breach of trust they have experienced, and they have fallen out of the medical system.”

On Monday, Johns Hopkins announced that it would pay $190 million in damages to the class-action plaintiffs for the sexual abuse they suffered at its medical center and the psychological distress that persists. Now, the court will go about the strange business of distributing those funds to each of Levy’s victims. According to the Associated Press, each individual plaintiff “was interviewed by a forensic psychologist and a post-traumatic stress specialist to determine how much trauma she suffered and how much money she will receive”; their relative harms and eventual payouts will be determined based on a “four-tier damage matrix.” In a letter to the JHU community, Johns Hopkins Hospital officials said, “It is our hope that this settlement—along with law enforcement’s findings that no images were shared—helps all who have been affected to achieve a measure of closure.”

This is the cold legal solution: Thousands of women will have their experience plotted on a “damage matrix” so that a court can calculate their distress and cut them checks. But Levy did not just victimize thousands of women—he victimized a community, and his abuse of his Johns Hopkins perch threatens to reverberate across the city and the country for generations. As one of Levy’s former patients put it in a lawsuit filed last fall, the doctor’s victims “were generally poor, black, undereducated, and of course, female.” Attorneys spearheading the class-action suit against the university notified former patients by publishing a full-page notice in the Baltimore AFRO-American and buying up ad space on local hip-hop station 92Q. Johns Hopkins is one of the most powerful landowners and employers in the state of Maryland, but many of the surrounding communities are among the country’s most vulnerable. Steps away from the university’s top-tier scientific research facilities, Baltimore’s black residents suffer from extreme health disparities and severe income inequality. Some local residents refer to JHU as “the Plantation.” Even $190 million will not provide “closure” for that reality.

“Monetary compensation is the easy part,” says Dr. Stephen B. Thomas, a professor of Health Services Administration at the University of Maryland’s School of Public Health and the director of the University of Maryland’s Center for Health Equity.  “The harder part is making sure it never happens again, and recognizing that these communities are vulnerable at so many levels.”

Levy’s crimes won’t just affect the 8,000 women who sat on his examination table. The breach of trust that Levy’s actions represent will congeal into “a legacy that’s passed on to the next generation,” Thomas says. If women and their children stop seeing doctors, “the transference of distrust will be passed down by word of mouth, through family networks.” Thomas adds, “It’s very important to recognize that a community has been harmed, and that community, in my opinion, doesn’t just live in east Baltimore. The ripples extend across the black community.”

The Levy case is just the most recent incident that lays bare the long-standing “racial discord between black communities and white medical institutions,” as Thomas put it. A 2003 study by Johns Hopkins researchers found that black patients are more likely to distrust physicians than are white patients and more likely to be concerned about privacy violations and medical experiments. “There’s a broader context here that contributes to the hesitancy, leeriness, and distrust among these communities,” he says. “And that distrust has been earned; that distrust is legitimate.” In the 1950s, Johns Hopkins doctors treated a poor black woman named Henrietta Lacks for cervical cancer; when she died, its scientists harvested her cells without her family’s permission, then used Lacks’ cells to fuel scientific experiments and build a multibillion-dollar biotechnical industry around her DNA. Meanwhile, her family suffered in poverty, unable to afford their own health insurance. In the '90s, two JHU scientists ran experiments on local black residents, connecting with slumlords to lure families with small children into apartments coated with lead paint. When parents sued, a judge determined that researchers made those children “canaries in the mines” without their families’ consent.

These are headline-grabbing ethical breaches that inspire big lawsuits and celebrated books, but the day-to-day experience of urban health care speaks to a quieter tragedy. “The people living in the shadow of these institutions do not benefit from all the science and technology that’s being developed there,” Thomas says. “These communities should be the healthiest in the state.” Dr. Susan Reverby, a Wellesley historian who studies the ethics of public health and is an expert on the Tuskegee Institute’s infamous syphilis studies, says that high-profile incidents like the Levy case need to be understood in a greater context of health care disparities that reveal themselves in smaller, personal experiences. “Most of the research shows that it’s not usually the knowledge of incidents like Tuskegee that keep people from getting health care—it’s hearing about what happened to Grandma when she went to the doctor,” Reverby says. “The word Tuskegee gets used as a metaphor for attempting to give a voice to racist systems and bad experiences.”

In many ways, Johns Hopkins appears committed to improving its relationship with local residents. The university’s community physicians program—of which the East Baltimore Medical Center is a part—aims to extend the university’s medical services to surrounding neighborhoods. The university now sponsors an annual Henrietta Lacks memorial lecture, award, and scholarship dedicated to improving relationships between scientific researchers and their surrounding communities. Its researchers work with Building Trust, a Maryland organization dedicated to fostering positive and transparent collaborations between minority residents and scientific researchers. That’s why it seems so disingenuous for the university to suggest that a one-time monetary settlement will provide “a measure of closure” between its doctors and its patients. “No apology, no settlement, will solve these problems,” Thomas told me. “The ultimate response needs to be atonement—and atonement means making things better.”

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July 22 2014 1:17 PM

When Were You First Allowed to Go to the Park Alone? Slate Wants to Know.

Earlier this month, South Carolina mother Debra Harrell was arrested and had her 9-year-old daughter removed by social services. Her crime: Allowing the girl, who had a cellphone for emergencies, to spend her days at the park without an adult guardian. Many were outraged by Harrell’s arrest. New York’s Jonathan Chait called it a “convergence of helicopter parenting with America’s primitive family policy.” Bloomberg’s Megan McArdle wondered, “What the heck are we doing arresting parents for things that were perfectly normal 30 years ago?”

In the comments to Jessica’s Slate story about Harrell, many readers shared their stories about how much more permissive their upbringing was in the '60s, '70s, and '80s. “When I was a kid I ran miles around my home all day. My parents had no idea where I was or what I was doing,” was a typical sentiment. When Hanna wrote an article for the Atlantic about how American children are overprotected, there was a similar response: “as a 70s kid with my three sisters we ran around, out on bicycles and all the rest—we had to be back for supper—that was it.”

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Since the Harrell story seemed to hit a nerve, we want to hear from you in a more orderly fashion. We’ve set up a survey so that you can tell us when you were allowed to do things alone, such as walk to school, go to a playground, or use sharp tools. We also included questions for parents, about when they allow, or plan to allow their children to do those same things. We want to try to pinpoint when things changed, and who they changed for: Did kids who grew up less privileged or in rural spaces have more freedom than their wealthier and more urban counterparts? Does that difference persist today?

We’d love to have your input. Please take the survey by 8 p.m. ET Friday, and we’ll publish the results in an upcoming story on Slate.

July 22 2014 11:58 AM

The Duggars Are Not Good Representatives for the Anti-Choice Movement  

Republican-majority legislatures in many red states are gorging themselves on new laws to restrict safe, legal abortion out of existence, but things have been pretty stable for the women of Tennessee, a state that has 14 doctors providing abortion, compared to a mere eight in Alabama and two in Mississippi. Because of this, one in four women getting an abortion in Tennessee hails from out of state.

One major reason it's relatively easy to get a safe abortion in Tennessee is a state Supreme Court decision in 2000 that held that "a woman’s right to terminate her pregnancy is a vital part of the right to privacy guaranteed by the Tennessee Constitution," meaning that medically unnecessary abortion restrictions are largely unconstitutional.

Now anti-choicers are pushing back, advocating for a ballot measure called Amendment 1 that would amend the state constitution to single out abortion as the one medical procedure not covered by the privacy rights enshrined elsewhere in the state constitution. "Nothing in this Constitution secures or protects a right to abortion or requires the funding of an abortion," reads the proposed amendment, and activists on both sides of the issue are pouring money into the campaign to determine whether or not state legislators can be free to pass laws restricting safe abortion access in the state. "We've been trying to put this back to a neutral position to say that the legislators should be the ones setting this policy, not liberal courts," Lieutenant Governor Ron Ramsey told an audience at a fundraiser last November.

July 21 2014 3:27 PM

Why Are Poor Women Having Healthier Babies?  

A new study shows that the birth weight of infants—an indicator of baby health—born to poor women in the United States has improved since the late ‘80s. As the Washington Post reports, in 1989 one-in-six babies born to poor women were considered underweight (under 5 ½ pounds at birth), compared to one-in-32 babies born to wealthier women. In 2011, that gap had shrunk to one-in-eight underweight babies born to poor women, while the rates for wealthier women had remained unchanged.

The study, co-written by professors at Brown and Princeton, points to numerous reasons for why the birth weight of babies born to poor mothers has improved, including the Medicaid expansions of the ‘80s, the reduction of domestic violence,  decreasing smoking rates, and food supplementation programs. Though the Post links to a study showing that Medicaid expansion had a “modest impact” on babies’ health, other studies have shown that babies whose mothers gained coverage while they were in utero had lower rates of obesity and fewer hospitalizations related to a variety of disorders.

July 21 2014 1:13 PM

Ronda Rousey Made Women's MMA. Will She Be Its Downfall?

On February 23, 2013, 13,000 mixed martial arts fans streamed into the Anaheim Honda Arena, buzzing about feminism. They'd come to see the first women's fight in the UFC's 20-year history—just two years after UFC president Dana White vowed to "never" allow women into the Octagon, he'd agreed to put two women at the top of the night's bill. Outside the arena, burly spectators discussed the sport's civil rights moment in between play punches. Female fans came out in full force: One woman, standing in line for the bathroom, told me that she'd never before had to wait to pee at an MMA event.

The fans had come to see UFC history in the making, but they'd really come to see breakout star Ronda Rousey, the Olympic judo bronze medalist turned MMA powerhouse, and the woman who'd convinced White to change his mind. Her eventual win that night—Rousey caught competitor Liz Carmouche in her signature punishing armbar and forced her to tap out in the first round—was a foregone conclusion. And by the time the fight ended, the enthusiasm around a new era of female Ultimate Fighting Champions had already begun to dim. "I'd say it didn't disappoint," UncutSports commentator George Bedford said. "But it's kind of disappointing to think that there's no one [who can challenge Rousey]. We're going to see her fight Miesha Tate, or that other girl. I can't even pronounce that other girl's name."

July 21 2014 11:43 AM

Pro-Life Nurse-Midwife Who Won’t Prescribe the Pill Sues Family Planning Center for Not Hiring Her

Is “religious freedom” about being free to practice your faith, or just a generic cover story for any and all attempts to try to foist your beliefs on others? In this era of Hobby Lobby v Burwell, it’s understandable that many on the right have decided it’s the latter and are eager to start testing the limits of how much leverage the expansive new definition of “religious freedom” gives them to meddle with the private contraception choices of others.  Next on the docket: Attempting to force family planning centers to hire nurse-midwives who refuse to let patients plan their families, all in the name of “religious freedom.”

Sara Hellwege is a nurse-midwife in Tampa, FL who opposes the use of some of the most effective and female-controlled forms of contraception, such as the birth control pill. Despite that position, Hellwege applied for a job with the Tampa Family Health Centers. When asked by the human resources director about her affiliation with an anti-contraception group called the American Association of Pro-Life Obstetricians and Gynecologists, Hellwege admitted she would refuse to prescribe the birth control pill to anyone who wanted it. She was summarily told that prescribing the birth control pill was part of the job and was not hired.

Now, Hellwege is suing, with the backing of the Christian right organization Alliance Defending Freedom handling her case.  Both ADF and Hellwege throw the word “abortion” around a lot, falsely conflating non-barrier methods of contraception with abortion.  But the factual inaccuracy of Hellwege’s claims may not be an issue here, since the lawsuit argues that Hellwege is a victim of religious discrimination and deserves to be hired by a family planning clinic despite “her religious beliefs and association with the pro-life group AAPLOG.” Of course, the Supreme Court in Burwell v Hobby Lobby said that case covers all forms of contraception objected to in the name of religion, with no need for pseudoscience garble conflating ovulation suppression with abortion necessary, suggesting that the liberal use of the word “abortion” in this case is more about the continued right wing campaign to demonize contraception than anything else.

Win or lose, Hellwege’s case provides insight in how the war on contraception is shaping up. Direct assaults through legislation are going to be a much harder sell with contraception than abortion, so instead we’re getting the argument that someone else’s “religious freedom”—your boss, your nurse—entitles them to interfere with your ability to get contraception. Family planning centers are one place that women have long been able to trust will provide them contraception access without unnecessary hassle, and now the Christian right is trying to take even that away.

July 18 2014 11:17 AM

Hunger’s Disproportionate Effect on Women

In 2006, the U.S. Department of Agriculture adopted the term food insecurity to describe the “economic and social condition of limited or uncertain access to adequate food.” Like so much bureaucratic jargon, the phrase is clinical and opaque. Food insecurity may be more exact than the old term, hunger, but it doesn’t convey much about what it’s like not to have enough to eat on a regular basis.

This week, journalist Tracie McMillan has a multimedia piece in National Geographic that sheds light on the lived experiences behind the jargon. Forty-eight million Americans faced empty cupboards at some point in 2012, and three-quarters of them live in working households. The problem is not that food prices have gone up—thanks to federal subsidies, junk food is cheaper than ever. The problem is that real wages have gone down, which forces poor people to choose between paying their bills and buying food. This is true even for families that receive food stamps, and Congress’s decision to cut the Supplemental Nutrition Assistance Program last year certainly didn’t help matters. (I should disclose that I’m friendly with McMillan and have edited some of her work for Slate.)

McMillan takes aim at various misconceptions about poverty and hunger by profiling four families across the country. Think all you need to eat healthy on a budget is cooking skill? Talk to Jacqueline Christian, a mother of two who works full-time as a health aide and wouldn’t have the time or energy to cook even if she weren’t living in a homeless shelter. Think it’s impossible to struggle with hunger if you’re overweight? Spend some time with Christina Dreier, an obese stay-at-home mom in Iowa who skips meals in order to feed her kids tater tots and hot dogs from a local food bank. Think food banks are an adequate safety net for the food insecure? Go shop at one with Kyera Reams, another Iowa mom who tells McMillan, “We wouldn’t eat healthy at all if we lived off the food-bank food,” and who literally devotes most of her waking hours to cooking, canning, foraging, and gardening so that her kids can have fruits and vegetables.

What goes unsaid in McMillan’s article is that the task of feeding children on an inadequate budget falls primarily to women.

July 18 2014 10:18 AM

Bill Maher Is Gross

Bill Maher reminded everyone Thursday evening that no matter how progressive he claims to be, when it comes to women, he’s an old school misogynist. Despite a long history of being called out by both liberals and conservatives for his tendency to use sexist slurs, Maher still thought it appropriate to tweet this:

So much sexism packed into one tweet! As others have already pointed out,  Maher is making light of the serious problem of domestic violence. But he’s also trading on the tired stereotype of women as irrational children who need to be brought in line by more stable men. (See: Clark Gable or Cary Grant putting a hysterical woman in her place with a calmly delivered slap that swiftly reminds her of the proper order of things.)

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There’s also the matter of the “who’s trying to kill u” part of the tweet, a nice bit of ass-covering that turns domestic violence into self-defense. (Bill: If a woman is ever actually trying to kill you, slapping her probably isn't enough.) Maher may admire men of yore who slapped screaming women with aplomb, but he fails to have their courage of conviction. Also, his Israeli-Palestinian conflict commentary is dumb.

July 17 2014 3:02 PM

Science Has a Gender Problem. Science Just Made It Worse.

The cover of Science magazine’s special AIDS and HIV issue hit mailboxes on Wednesday: It shows the legs and minidress-clad torsos of transgender sex workers in Jakarta. The women have breasts but no heads. “Staying a step ahead of HIV/AIDS,” reads the display text, a winking inch or so away from their stiletto heels. Though transgender sex workers are a “key affected population” for the epidemic in Indonesia, they are often overlooked by government health services, which is ostensibly why Science chose to splash bits of their anatomy on its cover. If transwomen get ignored, though, it’s in large part due to prejudice—and in that respect the optics of the Science tableau do more harm than good.

The Slantist sex blog explains this car wreck of noble intentions pretty well. “Instead of showing viewers a humanizing glimpse into the lives of these women,” writes A.V. Flox, the cover objectifies their bodies. It uses their bare legs as bait to lure in male readers, and then reverses the readers’ expectations in a way that’s supposed to be…funny? “Interesting to consider how those gazey males will feel when they find out,” tweeted Science editor Jim Austin gleefully. Because transgender women with AIDS are great comedic fodder! “Am I the only one who finds moral indignation really boring?” he continued. If only.

July 17 2014 12:56 PM

Republicans Can't Stop Comparing Immigrants to Rapists

It's estimated that 60,000 to 80,000 unaccompanied and undocumented minors will cross the border seeking sanctuary from violence and adversity, a number only exceeded by the number of tales told by right wing politicians and pundits of the unspeakable horrors that these children supposedly bring with them. Along with disease and general sadness, apparently migrant children are also going to bring rape. 

"Our continued existence is at risk with what’s going on at the southern border," exclaimed Rep. Louie Gohmert, a Republican from Texas, during a House speech on Tuesday where he accused the Obama administration of causing the influx of new immigrants, many of whom are children, by being too lax with border security. "And they’ve committed at least 7,695 sexual assaults. You want to talk about a war on women? This administration will not defend the women of America from criminal aliens! By the thousands, and hundreds of thousands!"

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