Correlation is Not Causation: STI Edition

I wrote a piece for the Daily Dot about a new study on STI rates among men who hook up with men using smartphone apps, and how easy it is to misinterpret the results.

new study by the L.A. Gay & Lesbian Center and UCLA suggests that men who have sex with men and use hookup apps like Grindr are significantly more likely to have gonorrhea and chlamydia than men who have sex with men but do not use such apps. But before you panic and delete Grindr from your phone lest it give you an STI, let’s look at what the study does and does not actually show.

[...]Careless headline writers frequently mix up correlation and causation, spreading misinformation and stigma. Despite Lowder’s balanced take on the study, the headline of his own piece reads, rather alarmingly, “Study Suggests Grindr-Like Apps Increase Likelihood of Sexually Transmitted Infections.” This wording implies that using such apps increases an individual’s likelihood of contracting an STI, not that, in general, people who use such apps are also more likely to have an STI. It’s a fine distinction, but an important one.

Another important distinction is whether the participants contracted the STIs during the course of the study (while using GSN apps) or just happened to have them at the time that the data was collected. Here Lowder’s article is also unclear: “Specifically, geo-social app users were 25 percent more likely than their bar hopping comrades to contract gonorrhea, and 37 percent more likely to have picked up chlamydia.” And an article about the study at Advocate is headlined, “STUDY: Smartphone Hookup App Users More Likely To Contract Sexually Transmitted Infections.”

However, the actual study notes that the participants were tested for STIs at the same time as they were asked about their sexual behavior, including the use of GSN apps. This means that they did not necessarily contract the STIs while using the GSN apps, or after having used them. The infections could have preceded the participants’ use of the apps.

This is important because it can help untangle the question of why this correlation exists, besides the obvious hypothesis that using GSN apps can actually cause people to contract STIs at higher rates than other ways of meeting sexual partners. Perhaps people who already have STIs are more interested in using the apps because of the anonymity—it’s much less scary to tell a random person you’ll never meet again that you have an STI and need to use a condom than it is to tell someone who’s embedded in your social network. Or, on the more cynical side of things, people might feel less guilty about not disclosing an STI to a random app hookup than someone they’ve met in a more conventional way.

Or, maybe people who are attracted to “wild” and “risky” sexual situations are more likely to have STIs and more likely to use GSN apps. The common factor could be impulsivity or recklessness.

Read the rest here.

DSW Shoe Warehouse is Promoting Vaccine Denialist Jenny McCarthy

This is a short post to alert folks about a pretty crappy thing that DSW, a place where I ordinarily like to buy shoes sometimes, is doing:

Flyer for DSW's Jenny McCarthy eventTheir Facebook post about this is, for whatever reason, visible only to certain Facebook users (weird targeted advertising perhaps?). I can still see it, as can Rebecca Watson, who’s already written a post about it. The DSW post with this image reads:

Hey, NYC—don’t forget!! Tomorrow we’ve got a BIG Shoe Lover party at DSW Union Square. Come shop amazing deals, grab an exclusive offer, and get the chance to meet Shoe Lover Jenny McCarthy!*

Wednesday, April 9 from 5–7 p.m.
DSW Union Square
40 E 14th Street | New York, NY 10003

RSVP and get full details: http://bit.ly/OoAVNt
See ya tomorrow!

*Participation in the event will be on a first come, first serve basis—so get there early! Line starts at noon.

I commented with the following:

Hey DSW, why are you hosting this vaccine denialist? Her continued claims that vaccines cause autism are scientifically incorrect and extremely dangerous. Parents who refuse to vaccinate their children threaten their own children’s health and that of other kids who are unable to be vaccinated for medical reasons. Several cities have already had outbreaks of diseases that are entirely preventable by vaccination and previously much rarer; parents refusing to vaccinate their children is a major cause of this and Jenny McCarthy actively promotes this dangerous idea.

I know your company’s about shoes, not healthcare, but it’s irresponsible of you to promote this person. I’m not shopping here again until this is canceled or apologized for.

They responded:

Hey Miri! We’d like to hear more about your concerns. You can email us at: [email protected]

And I responded again:

Thank you for your response. However, I have already stated my concerns, and I will not do so through private email when your event is *public*. Others deserve to know.

Here is more information about McCarthy and the very real harms she has brought to children and their families:

http://nypost.com/2014/03/18/anti-vaccine-activist-jenny-mccarthy-mother-of-plagues/

http://blogs.seattletimes.com/opinionnw/2014/04/04/anti-vaccine-measles-ignore-jenny-mccarthy/

http://jennymccarthybodycount.com/Anti-Vaccine_Body_Count/Home.html

Those links, by the way, are a great place to get started if you don’t know much about McCarthy and her promotion of dangerous and false vaccine myths.

We’ll see what comes of this, but for now, if you want to help us put some pressure on DSW, please email them at the address they provided ([email protected]), participate in the conversation on Facebook if you can see it, or tweet them @DSWShoeLovers.

As Rebecca also mentioned, Chili’s recently responded really well to a similar controversy. Hopefully DSW shapes up and does the same.

Screencap of the discussion on DSW's Facebook page, which isn't visible to everyone for some reason.

Screencap of the discussion on DSW’s Facebook page, which isn’t visible to everyone for some reason.

Update: Avi weighs in.

Some Evidence Against Shame and Stigma as Weight Loss Motivators

[Content note: weight/size stigma and discrimination]

It is considered self-evident by plenty of people that shaming fat people for being fat gets them to stop being fat. That’s why a common reaction to body/fat positivity campaigns is that they’re going to make people think it’s “okay” to be fat. As opposed to…not okay.

However, even if we begin with the presumption that it’s a net good for fat people to stop being fat, research evidence is rapidly piling up that suggests that shaming and stigmatizing them won’t work. In fact, it may have exactly the opposite effect.

In a paper recently accepted for publication in the Journal of Experimental Social Psychology, the authors provide this overview of research on this topic:

Media attention to obesity has increased dramatically (Saguy & Almeling, 2008), as has discrimination against overweight and obese individuals (Andreyeva, Puhl, & Brownell, 2008). Overweight individuals are often portrayed in the media as lazy, weak willed, and self-indulgent (Puhl & Heuer, 2009), and as a drain on the nation’s resources (Begley, 2012). Because stigma can be a potent source of social control (Phelan, Link, & Dovidio, 2008), some authors have suggested that stigmatizing obesity may encourage people to lose weight (Bayer, 2008, Callahan, 2013 and Heinberg et al., 2001), and policies that utilize potentially stigmatizing elements (e.g., BMI report cards) are becoming more prevalent (Vogel, 2011). Little evidence exists, however, that stigmatizing obesity promotes weight loss. In fact, among overweight individuals, experiencing weight-stigmatization is associated with greater reports of maladaptive eating behaviors (e.g., Haines et al., 2006 and Puhl and Brownell, 2006), increased motivation to avoid exercise (Vartanian & Novak, 2008; Vartanian & Shaprow, 2010), and poorer weight loss outcomes among adults in a weight-loss program (Wott & Carels, 2010; but see Latner, Wilson, Jackson, & Stunkard, 2009). Furthermore, experimentally activating weight stereotypes decreased overweight women’s self-efficacy for exercise and dietary control (Seacat & Mickelson, 2009). Collectively, these findings suggest that stigmatizing obesity has negative behavioral consequences that may increase, rather than decrease the weight of overweight individuals.

The paper also reviews research suggesting that the reason this happens is because of something called identity threat. When an individual has an identity that they know is stigmatized and something happens that triggers their awareness of that (such as a joke about the identity or a person who invokes negative stereotypes about it), the individual may experience negative effects. Some of these are physical, such as increased physiological stress response. Some are psychological, such as feelings of shame or anxiety. The person may try to act in ways that “compensate” for the flaws others may perceive in them or avoid situations in which people might think poorly of them (for an overweight person, this may include eating with people or going to the gym).

In theory, all this stress, anxiety, and effort depletes cognitive resources available for other activities that require what is known as executive function–mental tasks such as regulating emotions, setting goals, using short-term memory, and so on. Research has shown that when people of various stigmatized categories are reminded of those stigmas and stereotypes, their cognitive performance on a variety of tasks worsens.

The researchers in this study hypothesized that feeling identity threat would decrease participants’ ability to subsequently regulate their food intake. Specifically, they tested whether or not exposure to news articles about weight stigma would actually increase the amount of calories participants consumed. They believed that the participants who would be most affected would be those who believe themselves to be overweight, regardless of their actual weight, because they would be the ones who would feel identity threat when reminded that weight stigma exists.

The participants were 93 female college students (45% White, 24% Latina, 18% Asian/Pacific Islander, 3% African American, 10% other races). Prior to the study, they had filled out a survey that included a few questions about weight (the rest were just there to hide the purpose of the survey). When they arrived at the study, they were told that the purpose was “to examine correspondence among verbal, nonverbal, and physiological signals.”

They were randomly assigned to one of two conditions. In the test condition, they read an article called “Lose Weight or Lose Your Job,” which was compiled from actual news stories and described the discrimination that overweight people may face in the workplace. In the control condition, the participants read a nearly-identical article that was about smoking rather than weight.

Afterward, they were led to another room and asked to wait for the experimenter to return. The rooms had bowls of snacks that had been weighed prior to the study, and the participants had the opportunity to eat some of the snacks while they waited for 10 minutes. They were then asked to return to the previous room to complete a final questionnaire.

One of the measures on the questionnaire was called “self-efficacy for dietary control.” Self-efficacy refers to one’s sense of having the ability to do something and control one’s outcomes in that domain. This particular measure assessed the extent to which participants felt they could control their eating, avoid unhealthy foods, and so on. Various studies suggest that having a sense of self-efficacy is more important in terms of actual behavior than other factors, such as believing that the behavior is healthy or important. (For instance, here’s an example involving elderly people and exercise.)

The results were pronounced. In the weight stigma condition, women who perceived themselves to be overweight ate significantly more calories than those who did not perceive themselves as overweight. In the control condition, there was no significant difference:

The interaction between perceived weight and article type.

The interaction between perceived weight and article type.

Furthermore, women who perceived themselves as overweight had significantly lower self-efficacy for dietary control in the weight stigma condition than in the control condition, while women who did not perceive themselves as overweight actually had higher self-efficacy in the weight stigma condition than in the control condition.

This means that, within the context of this experiment, women who perceive themselves as overweight increase their food intake in response to hearing about stigma against overweight people and feel less capable of controlling their food intake. The very people being targeted by this information in ways many people think are helpful are actually being harmed by it, not only in the obvious emotional sense but even in their ability to control what they eat.

One really notable finding in this study is that actual weight did not correlate with either calories consumed or self-efficacy in either condition. Perceived weight was the relevant variable. I’ve often heard people argue against the body positivity movement because but if fat people don’t think they’re fat then how will they ever stop being fat?! Ironically, the women who did not perceive themselves as overweight had higher self-efficacy in the weight stigma condition than in the control condition.

One weakness of this study is that it is unclear whether or not the participants who increased their food intake did so consciously–or deliberately. If it was unconscious and not deliberate, then this finding may fit with previous findings about identity threat. If not, it’s still an important finding, but it’s probably easier to get people to change mental processes that are conscious and deliberate as opposed to those that are subconscious and unintentional. It’s also possible (though probably unlikely) that the women in the weight stigma condition purposefully ate more as a sort of symbolic protest. Oh, you’re going to fire me because of what I do with my own body? Well, fuck you, I’ll eat as much as I want.

Another limitation is that the type of stigmatization invoked in this experiment isn’t quite what overweight people might actually experience in their day-to-day lives. While articles like the one used in the study are common, the idea behind stigmatizing people so that they lose weight is usually more direct: for instance, telling them they need to lose weight, penalizing them for being overweight, and so on. Telling a study participant that they’re fat and ugly and need to lose weight would probably never pass an IRB review, but it would be a more naturalistic scenario, unfortunately.

While the sample used in this study is more racially diverse than many other samples in psychology studies, that really isn’t saying much. The researchers did not discuss any racial disparities in the data, but that would be an interesting direction for future studies. Also, all of the participants were young women, so it’s unclear how well this generalizes to older women and men of all ages.

With research like this, it’s important to remember that the findings should be interpreted much in the way that the statement “consent is sexy” should be interpreted. Namely, you should get consent because it’s the right thing to do, not because it’s “sexy.” Likewise, you should refrain from shaming and stigmatizing fat people because it’s the right thing to do, not because shaming and stigmatizing them doesn’t work anyway. Activists rightly criticize research like this for suggesting the implication that we should stop shaming fat people because it doesn’t get them to lose weight, rather than because it’s a shitty thing to do. That said, I don’t think that’s an implication that the researchers mean to give. We should conduct, support, and read research about how human motivation works (and how everything else works) because it’s important to know. This is just one piece of that puzzle.

It is my hope, though, that studies like this will work where “don’t be an asshole” won’t. The most important thing to me is for people to stop stigmatizing and discriminating against fat people, whatever the reason they stop doing it, because it’s harmful and needs to stop. Then maybe we can make these people understand why they were wrong to do it.

However, this research also opens up a lot of tricky questions. If shaming people who are overweight did actually help them lose weight, would more people think that this is an okay thing to do? If shaming people who do things that most of us would consider Definitely Bad, like rape or theft or even saying racist things, worked, would that be okay to do? Many would probably say yes to the latter but no to the former.

What is clear, though, is that human motivation (and reasoning in general) often works in ways that seem counterintuitive. You might think that people would respond to the stimulus of “being overweight can cost you your job” with “well I’d better stop being overweight, then!” But that’s not necessarily the case.

~~~

Major, B., Hunger, J.M., Bunyan, D.P., Miller, C.T. (2014). The ironic effects of weight stigma. Journal of Experimental Social Psychology, 51: 74-80.

Herbal Abortions and Editorial Responsibility

Content note: graphic descriptions of abortions and miscarriages

Being both a feminist and a skeptic means walking the fine line of critiquing the way science and medicine are practiced without denying their importance and validity, of empowering individuals who have faced abuse by these institutions without promoting at-best useless and at-worst dangerous pseudoscience to these individuals instead.

I was reminded of this ever-present tension when I read a book of essays called Listen Up: Voices from the Next Feminist Generationedited by Barbara Findlen. One of the essays was titled “Abortion, Vacuum Cleaners and the Power Within,” and the subject was the author’s negative experiences with what she called “clinical” abortions–that is, abortions performed by someone licensed to perform abortions.

The author, Inga Muscio, describes the several clinical abortions she had: they were painful and terrifying:

Have you any idea how it feels to willingly and voluntarily submit to excruciating torture because you dumbly forgot to insert your diaphragm, which gives you ugly yeast infections and hurts you to fuck unless you lie flat on your back? I had to withstand this torture because I was a bad girl. I didn’t do good, I fucked up. So I had the same choice as before, that glowing, outstanding choice we ladies fight tooth and nail for: the choice to get my insides ruthlessly sucked by some inhuman shit pile, invented not by my foremothers, but by someone who would never, ever in a million years have that tube jammed up his dickhole and turned on full blast, slurping everything in its path.

Muscio, who is very clear about her opinions on “Western medicine” (she at one point refers to it as “that smelly dog who farts across the house and we just don’t have the heart to put out of its misery”), eventually gets pregnant again, and this time she tries something else:

I started talking to my girlfriends. Looking to my immediate community for help led me to Judy, the masseuse, who rubbed me in places you aren’t supposed to rub pregnant ladies. She also did some reflexology in the same vein. Panacea told me where to find detailed recipes for herbal abortifacients and emmenagogues. Esther supported me and stayed with me every day. Bridget brought me flowers. Possibly most important was the fact that I possessed not one single filament of self-doubt. With that core of supportive women surrounding me and with my mind made up, I was pretty much invincible.

So, one morning, after a week of nonstop praying, massaging, tea drinking, talking and thinking, I was brushing my teeth at the sink and felt a very peculiar mmmmbloommmp-like feeling. I looked at the bathroom floor, and there, between my feet, was some blood and a little round thing. It was clear but felt like one of them unshiny Super Balls. It was the neatest thing I ever did see. An orb of life and energy, in my hand.

But lest you think Muscio intends this as a solution just for herself, she concludes, disturbingly:

Concentrating on the power within our own circle of women was once a major focus of the women’s health movement. I think we would benefit from once again creating informal health collectives where we discuss things like our bodies and our selves. If we believed in our own power and the power of our immediate communities, then abortion clinics, in their present incarnation, would be completely unnecessary. Let the fundamentalist dickheads burn all those vacuum cleaners to the ground. if alternative organic abortions were explored and taken more seriously, there wouldn’t be much of an abortion debate. Abortion would be a personal, intimate thing among friends.

Can you say Amen.

I finished the essay feeling confused. Although Muscio explained that “clinical” abortions were painful and felt wrong to her, she did not even attempt to explain her fury at abortion providers (whom she seems to think are all men). She did not explain why (or even whether) a painful and scary medical procedure that aborts a fetus is any different from a painful and scary medical procedure that stops a tooth infection or removes a tumor. Would she advocate “alternative organic” methods for those problems, too?

Her graphic imagery of vacuum cleaners, blood, and gore is never explained or justified in any way. She just doesn’t like the idea of abortions, and this, apparently, is reason enough to let abortion clinics go extinct.

Muscio further erases the fact that women, too, can and do perform abortions, and her implication that only women can understand the female reproductive system is extremely cisnormative (and also simply wrong; any doctor who has spent years studying those organs and operating on them and helping to keep them healthy surely knows more about them than I, a cis woman, do).

But I think I’m most disturbed not by Muscio’s ideas, but by the editor’s decision to publish them in this anthology.

How would a young person, perhaps not very knowledgeable about abortions, perhaps who has grown up being told they are awful and immoral, perhaps in need of (or at risk of needing) an abortion themselves, react to reading this piece? What decisions would they make about their health? I’m wondering if the editor thought about this before choosing to publish the essay.

On one hand, I see the value of publishing and reading all kinds of narratives about reproductive health, including this one. In our rush to portray abortion as a standard, no-big-deal sort of medical procedure, advocates for reproductive rights sometimes lose sight of the fact that, like any other medical procedure, abortion can be terrifying and traumatic completely independently of the fact that it’s so stigmatized.

Fear of medical procedures (and fear of pain) is something that people are expected to magically “outgrow” when they stop being children. Some do, but some don’t. Doctors don’t always know how to respond to adult patients with extreme fear, and often respond without empathy or compassion. This is only one of many reasons some people turn to practitioners of alternative medicine for help.

Understanding this is essential if we are to help people find healthcare that works (both by actually getting them physically better and by treating them with dignity and care). But the essay was presented in the book without any sort of commentary. While the book’s editor isn’t necessarily condoning or supporting the ideas in the essay, she is nevertheless promoting them by giving them wider circulation than they would otherwise have.

People may read the essay and become convinced that prayer and herbal tea can actually abort a fetus, and that getting an abortion performed by a medical professional is always a horrible experience to be avoided at all costs. That someone would end up with an unwanted child is probably the best case scenario of taking Muscio’s advice, as alt-med remedies can be actively harmful and dangerous.

(In fact, in the essay, Muscio elaborates on the specific “herbal remedies” she used. One of them was pennyroyal, which was implicated in the death of a woman who used it to try to induce an abortion. She didn’t know that she had an ectopic pregnancy. In general, the history of herbal abortifacients is, as i09 puts it, terrifying.)

Giving people medically accurate information about reproductive health is a crucial part of progressive activism. While one might argue that left-wing distortions of science and medicine are more well-intentioned than their right-wing counterparts, the end result is absolutely identical: people don’t understand how their bodies really work, how medicine works, which medical interventions are supported by the evidence and which are not. People feel ashamed of seeking out medical care that works.

I know that there are compelling reasons to publish this essay as is. I can understand why the author of this book might’ve done it. But I wouldn’t. It seems irresponsible.

~~~

P.S. Many of the other essays in the book were actually pretty cool. Here are my favorite quotes.

Help Stop Ohio’s Terrible New Anti-Abortion Bill

[Content note: abortion]

Note: If you already know all about Ohio’s terrible new anti-abortion bill, scroll all the way to the end to find out how to try to stop it. If not, read on.

Last Tuesday night, I and–at times–150,000 other people stayed up to watch the livestream of the 12-hour filibuster in the Texas state legislature. State senator Wendy Davis and her fellow Democrats helped prevent (temporarily) the passage of what would’ve been one of the most restrictive anti-abortion bills in the country. Davis overcame exhaustion, hunger, and her Republican opponents’ bad-faith attempts to get her to go off-topic (in Texas, filibusters must remain “germane” to the bill at hand), to claim that she was breaking rules, and, when the going got tough, to cheat and try to pass the bill after the midnight deadline.

Unfortunately, Davis’ victory was only temporary, and Texas is only one of the the states where reproductive rights are constantly under assault.

My home state of Ohio (I use the word “home” loosely here) just passed House Bill 200, a bill similar to the one that got filibustered in Texas, except worse. Some of its provisions include:

  • Doctors must explain to patients seeking abortion how their fetus’ nerves develop, and to tell them that, even in the first trimester, a fetus can feel pain. There is no scientific evidence of this.
  • Doctors must also tell patients that abortions are linked to breast cancer. There is no scientific evidence of this either.
  • As in the Texas bill, abortion providers in Ohio must be within 30 miles of a hospital, but here’s the new catch–it cannot be a public hospital. So if there are no non-public hospitals within 30 miles of an abortion clinic, then the clinic must shut down.
  • Doctors must inform patients seeking abortions exactly how much money the clinic made from abortions within the past year, and how much money the clinic stands to lose if the patient chooses not to get an abortion. In case it’s unclear, the point of this is to warn patients that there is a “conflict of interest” involved in providing abortions because clinics can make money from them. This is ridiculous because any medical procedure can make money for doctors and hospitals.
  • Before this bill, patients seeking abortions in Ohio were already required to view an ultrasound of the fetus. Now, the doctor must describe the fetus visually and explain the current development of its features. Although the bill doesn’t stipulate what type of ultrasound it has to be, it does require for it to produce a clear image of the entire body of the fetus, and for first-trimester patients, that probably requires an invasive transvaginal ultrasound. Victims of sexual assault are not exempt, and the patients must pay extra for the ultrasound.
  • The mandatory wait period for an abortion in Ohio used to be 24 hours; now it will be 48 unless there is a dire medical need to terminate the pregnancy. Again, victims of sexual assault are not exempt. While some people may claim that it shouldn’t be a big deal to have a wait a day or two, remember: restrictions like these disproportionately impact teenagers, the poor, and those who live in rural areas. For a teenager to miss school and get a ride to an abortion clinic without their parents’ knowledge is difficult enough already; doing it twice is even harder. Same for a poor person who has to skip work, and for a person living in a rural area who has to drive a long way to get to an abortion clinic (and it’ll be even longer thanks to the closures that will occur as a result of this bill). In any case, having to wait, especially having to wait a longer period of time, causes stress and anxiety. These politicians seem to be hoping that that stress and anxiety somehow dissuades the person from getting the abortion.
  • Before, a doctor could get a medical waiver to bypass these restrictions if the pregnancy was causing health problems. But now, doctors will only be able to get those waivers if the potential health risks are so great that the pregnant person could die. Anything less than death, apparently, is no big deal.

These abortion restrictions are like the proverbial frog in boiling water. They do it gradually–a 24-hour waiting period here, a mandatory ultrasound there. So what if doctors must have admitting privileges at nearby hospitals? Doesn’t that make abortion safer? (No.)

But before you know it, abortion is nearly or completely unavailable in a given state, and the degree to which it is unavailable varies according to how much money, status, and support you have. Those people who will be most harmed by an unplanned-for and unwanted child will also be the ones for whom abortions are hardest to access. This is unconscionable and it must stop.

Furthermore, most of these restrictions are predicated on the belief that pregnant individuals cannot be trusted to make decisions about their own bodies on their own. They need waiting periods. They need to be shown ultrasounds. They need their fetus’ development described to them. They need to be informed, as though they are completely clueless and ignorant, that doctors make money when they perform medical procedures.

Of course, the point of the bills is not to make abortion safer. This must be stressed over and over again. The point of the bills is to make abortion difficult or impossible to access. Do not fall for the Republicans’ paternalistic claptrap about how they’re just trying to keep women (they think everyone who gets an abortion is a woman) safer. They’re trying to outlaw abortion, slowly and surely.

How do I know? Many reasons, and I’ll use the very similar Texas bill as an example. Texas Republican legislator referred to opponents of the filibustered bill as “terrorists.” Texas Governor Rick Perry, defending the bill, said that “the louder the opposition screams, the more we know we’re doing something right.” (Yes, that is as rapey as it sounds.) Texas Lieutanant Governor David Dewhurst said that the protesters who prevented the bill’s passage “disrupted the Senate from protecting unborn babies.” Where’s the compassion and the concern for safeguarding women’s health now?

As I mentioned, the Ohio bill has already passed. It was included last-minute in a state budget bill, leaving reproductive rights advocates no time to organize any resistance like they did in Texas.

However, Ohio Governor John Kasich has until midnight tomorrow (Sunday) to veto any or all of the bill’s provisions. Kasich, a Republican, has said that he opposes abortion, but maybe even he will realize that this is just too much.

Here’s what you can do: call Gov. Kasich at (614) 466-3555 or email him here and let him know you oppose House Bill 200. I just did. Remember what I wrote about online activism? We can make a difference.

Correlation Is Not Causation: The Marriage Edition

Steven Crowder–that guy who wrote an article on Fox News’ website gloating about his “perfect wedding” and sanctimoniously censuring people who have sex before marriage or *clutches pearls* drink at the wedding–is back. (Actually, he’s probably been back; I just haven’t been following his pearl-clutching screeds.)

This time, Crowder, who presumably still has that newlywed glow, wants to tell you why you should get married. Yes, you!

Crowder runs through the typical list of established correlations about married people. They make more money. They have more money. They have more and better sex. It’s better for the children. They’re more productive at work (crucial in our capitalist society). They’re healthier.

Crowder is writing this article because he seems to be under the impression that there is a War on Marriage going on:

Sadly, marriage has become a punchline in today’s society. From referring to the wife as “the old ball and chain” to nearly every poorly written sitcom that we watch, the message we’re sending to today’s generation is clear… Marriage = no fun.

Men on TV constantly joke about how wives are incredibly expensive, demanding and overall vacuums of all things fun. By that same token, the women complain about their fat, lazy, insensitive husbands as they swoon over their trimmed, manicured and chest-waxed Hollywood counterparts.

[...]I know plenty of people my age that will never get married because they genuinely believe the false cultural meme that marriage has sadly become.

Although marriage is certainly portrayed as boring in pop culture, the reality is that, especially among Crowder’s ilk, marriage is still largely considered the only acceptable choice for straight people (gay people, on the other hand, need to either choose to be straight, live a life of celibacy, or have those adorable cute little gay relationships in which they live together and have cats but never actually do anything annoying like ask for the right to get married).

Aside from the fact that this article is completely unoriginal and pointless–there is no war on marriage, people–Crowder displays an incredible lack of intellectual curiosity. That is, he fails to ask where all of these wonderful benefits come from.

Where do they come from?

Are married people healthier, richer, and more productive than straight people because marriage is “naturally” the best state of adult humans to be in? Or might it be because of all the benefits our society has conferred to married couples, the privilege that we have afforded to the status of being married?

And what about that awkward moment when most of the correlations Crowder mentions are just that–correlations? Do married people get richer, or are rich people more likely to be able to afford marriage? Does marriage make people healthier, or are healthier people more likely to find and keep partners?

Actually, these are not rhetorical questions. I really am curious. But because the only studies Crowder linked to were correlative studies (and they were all found on websites like the FRC and FamilyFacts.org, but whatever), I don’t actually know the answers.

In his rush to prescribe marriage to every single person man in America, Crowder overlooks quite a few things. Some of the oversights are quite callous:

Okay so you may not want kids. You may despise them. I get it. Sticky hands. Let’s say you’re just another selfish, narcissistic bachelor (or bachelorette) who quite frankly, isn’t deserving of the unconditional love you may oh-so-luckily find. You just want the sex. Statistically, not only do married people have more sex, they have better, more satisfying sex. If the two of you should hold off on sex until marriage, those statistics become even more promising. Here’s a perfect example of where Hollywood gets it wrong. In the real world, while Alfie fruitlessly toiled away at picking up harlots from the bar, suffering a mean case of whiskey-wiener, Mr. Cleaver was getting busy on the regular. Them’s the real breaks.

It appears that Crowder is totally okay with the idea of a man pretending to be invested in marriage and family for the purpose of getting regular sex. (Also, “picking up harlots from the bar”? What century is this?)

The rest of the piece, too, is infested with sexism, from the implication that wives are supposed to keep husbands in line down to the pointless and tacky sandwich joke at the very end. For example:

Married men in particular, have higher employment rates, work longer hours and receive better wages. It’s time to stop wading through puddles of your own filth as you reach for the hotpockets and have a dame whip you into shape. You’re welcome.

Why the hell is that a woman’s job? I don’t want to get married if it means “whipping” some lazy slob into “shape.” This, by the way, is a perfect example of the fact that it’s conservatives, not feminists, who have the most sexist and unflattering opinions of men. I at least accept the remote possibility that a man might, you know, not be a lazy slob who needs to “stop wading through puddles of [his] own filth.”

Crowder also correctly notes that married people “qualify for more benefits/financial incentives than lonely, single folk,” but fails to explain how the fuck this is fair, and why exactly the government is in the business of encouraging procreation when we’ve got plenty of humans on the planet as is. Big Government is totally okay with this Republican when the purpose is to encourage procreation.

Before the icky sandwich joke, Crowder closes his screed with this:

Picture coming home every night to your best friend, your greatest fan, and your number one supporter. She (or he) makes each good day better, and each bad day good again. Every day, you get to live what is essentially a 24/7 sleepover party with the greatest friend you’ve ever had.

That does sound like a pretty awesome deal–for me, because I do happen to be a person who wants a stable, long-term relationship. Believe it or not, not everyone does!

But notice how nothing in that paragraph requires a certificate from the government saying that you are married. Nothing in it requires standing in front of all of your friends and family wearing fancy clothing and vowing to love and cherish each other till death do you part.

Edit: My friend Michael has also written a post about this that’s making me guffaw loudly. A snippet:

Regarding this whole “It’s even better if you wait!” thing, though, I’m a bit more skeptical.  The trouble with measuring sexual satisfaction is that it’s entirely subjective, and based on comparison within your own experience.  If you’ve only ever had sex with one person, then that’s the best sex you’ve ever had.  Add onto that the fact that people who wait until marriage to have sex are routinely told that theirs will be the best sex ever, and all those filthy fornicating whores out there will never truly be happy, of course they’re going to say that their sex lives are great (and hey, if it’s working for them, whatever).  If you only ever give someone an Oreo, and make sure that you talk up Oreos all their life and stress to them that all other cookies suck, then they’ll probably think Oreos are the best cookie, too.

Save the People, Not the Boobies: The Ethics of Breast Cancer Awareness

Few ad campaigns make me as misanthropic as the breast cancer awareness ones I’ve been seeing at an especially high volume for the past month:

There’s also this video (NSFW).

I hate these campaigns for many reasons. First of all, they make breast cancer all about boobs. Yes, it has “breast” in the name, but reducing an illness as complex and life-shattering as breast cancer into a cutesy “save the boobies!” campaign seems callous and inappropriate.

I’m not sure everyone would even agree that the prospect of losing your breasts is the worst thing about breast cancer, and yet that’s what these campaigns almost universally target. It’s not the “boobies” or “ta-tas” that need to be saved–it’s the human beings who have breast cancer.

It’s even worse when the campaigns are created by and/or targeted at men and involve that hint-hint-nudge-nudge assumption that men should care about breast cancer because men love tits. Never mind that men can get breast cancer too, and never mind that men care about breast cancer not (just) because they care about boobs, but also because they care about their friends, girlfriends, wives, mothers, sisters, daughters, and etc. who might get breast cancer, or who already have.

Campaigns like these also completely ignore women who have chosen (or been forced to) undergo mastectomies. If breast cancer research and awareness is all about “saving the boobies,” does losing your breasts mean you’ve lost the fight?

This preoccupation with breasts is probably what inspires awful ads like this one by the Cancer Patients Aid Association, an Indian NGO:

The text at the bottom reads, “One out of every eight women develops breast cancer in her lifetime. Early detection helps recovery. Get yourself examined before it’s too late.” So there you have it. If you get a mastectomy, you’re “making yourself ugly.”

This is all to say nothing of Susan G. Komen for the Cure, the hypocrisy and reactionism of which should by now be well-known. (Incidentally, the former Komen executive who was responsible for that move was not content with merely that; she just had to write a book-length screed against Planned Parenthood, as well.) This unethical organization seems to be the beneficiary of most (if not all) of the sexualized ads I’ve seen. I still refuse to give them a single cent, which is difficult given how easy it is to accidentally pick up one of those pink-ribbon-branded products at the grocery store.

On the bright side, this is a great opportunity to explain what feminists mean when we prattle on about “objectification” and “sexualization,” which are closely related concepts that often (but not always) occur together. Objectification is the reduction of a person to their body parts (usually the sexual ones; hence the frequent co-occurence of objectification and sexualization). An advertisement that objectifies women might show, for instance, a single female leg in front of a flashy car, or a woman lying in a martini glass–literally like an object to be consumed. Sometimes men are objectified too, but that seems to be rarer. Ads that objectify people often don’t show their faces (or eyes), thus making them seem less like people and more like bodies.

Sexualization, meanwhile, is when a person (again, usually a woman) is represented in such a way as to arouse the viewer or otherwise connote sex when the actual purpose of the representation has nothing to do with sex at all. You wouldn’t call pornography “sexualization” because the purpose of pornography is to depict sexual acts and to be arousing. But when an advertisement designed to sell cars or alcohol–or solicit donations for breast cancer research–portrays women in a sexual way, that’s sexualization.

The objectification and sexualization of women in the media has a great deal of negative effects, both on an individual level–for the people who view them–and on a cultural level. Check out the work of Jean Kilbourne if that interests you.

However, I am not a marketing expert. If I were, and if I were charged with designing an ad campaign that elicits as much attention and donations for breast cancer research as possible, there’s a good chance I would feel compelled to create an ad like this, because there’s a good chance that this is the kind of ad that works best.

Hence the misanthropy I mentioned earlier. Marketing people know what they’re doing. If this is really the best way to get people to pay attention to this important cause, I would say that not using ads like these is even more unethical than using them–at least until we shift our culture enough that we don’t need them anymore. But that still means that we’re choosing the lesser of two evils. I would rather more money went to breast cancer research than less, but I would also rather we stopped reducing women to their erogenous zones in our media.

After all, I don’t agree with this rubbish that men are “programmed” or “hardwired” by biology to be obsessed with breasts, at least not to the level that our society seems to think they are. As I already discussed when I wrote about public breastfeeding, the sexualization of breasts is not universal to all cultures and time periods. Even if “sex sells,” breasts don’t necessarily have to always be part of “sex,” and I think it would be beneficial to our society if they were not.

For the record, whether straight men’s love of boobs is entirely biological or not, I don’t think there’s anything wrong with it, as long as it doesn’t infringe upon public policy or trivialize serious illnesses. Besides, you can totally be an awesome (male) feminist and a boob enthusiast at the same time.

Edit: Here’s a great article that basically makes my point for me.

Abortion and Suicide: A Spurious Link

In South Dakota, it is now legal to require doctors to tell women seeking abortions that they are putting themselves at risk for suicide.

This move is brilliant from a PR standpoint. Unlike banning certain types of abortions entirely or, say, forcing women to undergo invasive screenings that are medically unnecessary, this seems completely apolitical when you first look at it. Don’t people deserve to be informed if they may be increasing their risk for suicide? Don’t we all agree that suicide is a Bad Thing?

However, something tells me that this is actually another attempt to scare women out of (what should be) a normal, socially acceptable medical procedure.

First of all, the inconvenient truth here is that credible research consistently shows little or no link between abortion and poor mental health. One 2008 study reviewed the literature and found that the only studies that seemed to show such a link had very flawed methodology, whereas the studies that were well-designed showed no links. (Damn liberal academics!) And here’s another study that showed no such links. And here’s a thorough debunking of a study that did claim such links:

Most egregiously, the study, by Priscilla Coleman and colleagues, did not distinguish between mental health outcomes that occurred before abortions and those that occurred afterward, but still claimed to show a causal link between abortion and mental disorders.

In other words, that study actually tried to use mental health pre-abortion to confirm a hypothesis about mental health post-abortion. This is simply not how you do science. And it’s especially bad here, because according to the American Psychological Association, guess what the best predictor of mental health post-abortion is?

Across studies, prior mental health emerged as the strongest predictor of postabortion mental health. Many of these same factors also predict negative psychological reactions to other types of stressful life events, including childbirth, and, hence, are not uniquely predictive of psychological responses following abortion.

That’s right. Shockingly enough, the best predictor of mental health is, well, past mental health. And poor mental health predicts poor response to all sorts of stressful events, of which abortion is only one example. Another one being, for instance, childbirth!

Compounding the bad science here is that, unlike physical side effects,suicide isn’t something that just happens to you suddenly and without warning. People don’t just suddenly wake up one morning and decide to kill themselves. Suicidality is a complex process that involves factors like genetics, family history, environment, social support, mental illness, and life circumstances. For instance, here are some things that, according to research, actually increase one’s statistical risk for suicide:

As you can probably surmise, not all of these correlations are also causations. While mental illness and drug addiction can actually cause suicidal behavior, being intelligent and being LGBT probably cannot. In the latter case, the causative culprit seems to be (surprise surprise) institutionalized discrimination and homophobia. Before I get too off-topic, let me point out the irony in the fact that, despite this well-known risk faced by LGBT youth, I don’t see any of these pro-lifers advocating for an end to homophobia.

That’s why something tells me that nothing about this court ruling actually has anything to do with suicide prevention.

Although the court’s ruling does at least acknowledge that abortion probably doesn’t cause suicide, it nevertheless states that “conclusive proof of causation is not required in order for the identification of a medical risk.” This is probably true, but it only makes sense from a physical health standpoint. If studies show that people who get a certain elective medical procedure are much more likely to, say, experience headaches or nausea or numbness, you don’t necessarily need a causative study to conclude that there’s a reasonable chance that these symptoms were caused by the procedure (assuming, of course, that there was no illness present that might be causing them). Furthermore, there’s a difference between saying “This procedure may cause you to experience cramps and headaches” and saying “This procedure may cause you to kill yourself.”

The truth is, mental health doesn’t work that way. A person who gets an abortion might experience mental side effects because of the stress of having gotten pregnant accidentally and been forced to decide what to do, perhaps without the support of a partner or family. Furthermore, any invasive medical procedure can be stressful and worrying for many people–especially one like abortion, which is consistently portrayed as more painful and dangerous than it really is.

And this is all made even more complicated by the fact that the faulty studies in question were actually studying mental health before the abortion. Perhaps a person with poor mental health is more likely to seek an abortion in the first place–say, if they feel that they aren’t mentally capable of raising a child at the moment.

Ultimately, decisions about what to tell a patient should be left up to the people who know most: doctors (with, of course, a reasonable amount of regulation to prevent malpractice). If a doctor can tell that a person seeking an abortion is going through a lot of mental distress, then that doctor may want to gently recommend counseling and perhaps give out some hotline numbers–and training doctors to recognize signs of mental health troubles is always a good thing.

But doctors should not be mandated to fearmonger to their patients. They should especially not be mandated to serve a pro-life agenda.

[Guest Post] What is Sensible Drug Policy?

It’s another guest post! In this one, my friend and fellow activist Frances discusses the parallels between good sex education and sensible drug policy, and why we need more of both.

Ever since you’re young, you’re taught that sex and drugs are just plain “bad.” Many high school health classes teach you that if you engage in these activities before (or even after) a certain age or point in your life, you are a weak, scumbag failure who will die with a spoiled reputation.

But where the hell is the other side of the story? Why don’t people ever seriously talk about sex and pleasure? Or drugs and fun? Why is it okay for the media to wave it in our face but crazy for our own parents and teachers to give us a healthy dose of balanced information? Our goal is to teach adolescents to “be responsible,” but they’re learning from irresponsible educators.

I founded SSDP (Students for Sensible Drug Policy) and joined SHAPE (Sexual Health and Assault Peer Educators) my first year at Northwestern University to try to get a more holistic view of these taboo topics. Sex and drugs both share intense politicization, widespread ignorance, and unforgiving stigma, but you know what I eventually learned?

Sex and drugs, in and of themselves, are NOT bad! A certain amount of irresponsibility is necessary to turn sex and drugs bad.

Before you start freaking out because you think I’m promoting sexual activity and drug use, let’s get this straight. There are certain “objective ideals” that we, as a society have created based on common sense and cold hard facts. Ideally, teenagers wouldn’t engage in sexual activity before the age of consent (16-18 in the U.S.), due to the fact that becoming sexually active requires a whole lot of responsibility, healthy communication, self-awareness, and maturity—characteristics that a lot of adolescents under the age of 18 haven’t acquired yet. And objectively, the best drug use is no drug use, given that every drug—whether legalized, criminalized, or medicinal—has the power to cause some sort of negative physical, mental, emotional, or developmental effect. Responsibility is key.

However, just because abstinence from sex and drugs is the “objective ideal” in many cases, does not mean that abstinence only is the objectively ideal way to educate people about sex and drugs. “Abstinence only” or “Just Say No” education is bad and irresponsible, because when we say BAD! or NO!, we never teach kids to think for themselves, or give them the proper tools to deal with these situations should they ever arise. Instead, when teens have questions like, “Can I get STIs from oral sex?” or “If Tommy can drink 9 shots in an hour, it should be fine for me, right?” their friends will answer, “I don’t know.”

Irresponsible sex education is what leads to the spread of STIs, unplanned pregnancies, sexual assault, teen-dating violence, unhealthy communication and our slut-shaming, victim-blaming, homophobic, rape culture. An adequate sex education is more than just about putting on a condom and getting tested. It’s about teaching teens to love their bodies, moving past stigma and encouraging an honest discussion so that we can reduce the possible harms of sexual activity. Simply labeling sexual activity as the root cause of all sex-related problems is too simple an approach with such a complex issue.

The same can be said for drugs. We have GOT to stop blaming drugs for drug addiction, DUIs, overdose deaths, academic failure, gang violence, rape, teenage drug dealers, and violent illegal drug trafficking. A “Just Say No” drug education based on scare tactics is too simple an approach with such a complex issue. The more extreme the scare tactics, the less likely it is that teens will respect what the words of their health teacher. The nastier the words we use to label and stigmatize drug users and abusers, less likely it is that people will proactively seek treatment. Alcohol itself is not hurting people, but people who use alcohol irresponsibly and decide to drive? That’s what destroys lives. Heroin itself is not responsible for overdose deaths, but a lack of education and respect for the powerful effects of the drug are fatal. A drug education that eliminates the stigma of drug use, emphasizes moderation and responsibility, offers a balanced “pros and cons” list on recreational drugs, and is truthful about the social norms of drug use is what will actually reduce the overall cost of drug use to society. This is known as “harm reduction,” the idea that with any harmful activity, there are necessary precautions we can take to make it “safer” and reduce harm, like fastening your seat belts before a drive!

Education rather than blame is crucial to changing risky behaviors and the policies that facilitate risky behaviors. Sex and drug education and sex and drug policies have a reciprocal relationship. Sex education that teaches women to “protect themselves from rape” makes it harder for rape victims to achieve justice in the court of law, because women learn to take on the burden of avoiding rape, while men are alleviated from the burden to not rape. As our gay rights policies slowly change, the movement will very likely go on to influence sex education surrounding LGBT issues. Our laws change our attitudes, and our attitudes change the way we educate. With drugs, it’s even more obvious. Drug education promoting the idea that drugs are “just plain bad” reinforces the public belief that drugs should be illegal forever. The criminalization of drugs creates the violent drug market that sucks adolescents into drug addiction and the criminal justice system. And when adolescents are addicted to drugs, engaging in violence, barred from higher education, unable to find treatment, and ultimately a way out of this lifestyle? We teach that drugs are bad.

I became the Drug Policy Dealer on YouTube to serve as the bridge between drug education and drug policy activism, integrating the skills of a peer sex educator, the lessons from countless articles I’ve read regarding drugs and drug policy, and just plain common sense. Northwestern University’s SSDP Chapter and The Drug Policy Dealer will be unique in that the main message we send is that sensible drug policy relies on the assumption that the majority of people will be sensible with their drug use. Like I said, it is irresponsible to only preach the negatives of drug use, without accounting for the fact that safe, responsible drug use does occur everyday. By the same logic, it is irresponsible to advocate for drug legalization without fighting for a more well-rounded, all-inclusive of drug and drug policy education as well.

Stay Sensible!

[Read more...]

A Sacrifice They're Willing to Make: Mississippi's War on Abortion

The last remaining abortion clinic in Mississippi is perilously close to shutting down thanks to a new proposed law, Mississippi House Bill 1390. The law would require that all doctors performing abortions be board-certified in obstetrics and gynecology (reasonable), and that they also have admitting privileges at a local hospital (not so reasonable).

The reason that’s not so reasonable is because Jackson, Mississippi, home of the besieged abortion clinic, has two hospitals with Christian affiliations, and any hospital can refuse to grant admitting privileges to a physician for any ol’ reason, such as that said physician is a godless heathen who wants to help women murder their unborn fetuses babies.

To make it even better, the law would give the clinic’s physicians (all of whom are board-certified OB/GYNs but only one of whom has admitting privileges) less than two months to acquire them. As Evan McMurry writes at PoliticOlogy, “This is part of the pro-life’s recent death-by-a-thousand cuts tactic: if they can’t overturn Roe v Wade outright, they’ll make accessing and performing abortions so onerous that the practice will be effectively impossible.”

But of course, as it usually is with these laws, things get even more ridiculous. From the HuffPo article:

The State Senate voted to pass the bill Wednesday, but it was held for further debate on Thursday, when lawmakers had an odd exchange over the bill on the Senate floor. Sen. Kenny Wayne Jones (D-Canton) asked Sen. Dean Kirby (R-Pearl), who chairs the Senate Public Health Committee, whether ending abortions in the state would force women to resort to dangerous, back-alley abortions.

“That’s what we’re trying to stop here, the coat-hanger abortions,” Kirby replied, in reference to the abortions provided at the clinic in Jackson. “The purpose of this bill is to stop back-room abortions.”

Okay, first of all. No reputable doctor performs abortions with a coat hanger. In fact, I’m just going to go out on a limb and amend my statement to say, No doctor performs abortions with a coat hanger.

All of the physicians in question are board-certified in obstetrics and gynecology–a certification that I’m pretty sure Senator Dean Kirby does not have.

Incidentally, you know when dangerous abortions do actually happen? When abortion is made illegal. Research invariably shows this. (I know, I know, Republicans don’t believe in science anyway, but it was worth a shot.)

The truth is that making something illegal, especially if that thing is considered absolutely necessary by many people, does not mean it won’t happen anymore. It just means that it’ll happen out of sight, and therefore without regulation. This is why countries that are more progressive than ours are starting to experiment with drug decriminalization, but that’s a whole other topic.

Drug policy is a different ballgame because, while there are many psychological and societal factors that may lead people to become addicted to drugs, most of us can agree that nobody needs illegal drugs in order to have a decent life. Abortion is another matter, however. Unless conservative lawmakers are willing to provide comprehensive sex education and low-cost (or free) birth control (not to mention end sexual assault), there may not be a way to eliminate the need for abortion. For instance, from a comment on the HuffPo article I linked to:

I live in Mississippi. Yesterday I taught classes in the poorest part of the Delta to pregnant or parenting teens on parenting skills. I would much rather teach classes to teens about safe, effective birth control. The state won’t let me. It doesn’t matter how many facts or statistics I roll out…nobody listens. I am frustrated beyond belief.

So that’s what we’ve got.

Anyway, because politicians in states like Mississippi refuse to provide the resources to prevent abortion from becoming necessary, they must face the fact that women are going to get them whether they’re legal or not. But they don’t face this fact.

In the quote from Senator Kirby, which I provided above, he states that his purpose in making abortion unattainable in Mississippi is to prevent women from having dangerous abortions. So basically, his argument is this: we’re going to restrict women’s access to a safe, standard medical procedure in order to prevent them from obtaining the potentially dangerous, unregulated version of that procedure, despite the fact that restricting the safe thing actually leads to an increase in the use of the dangerous thing.

Kirby’s reasoning makes such a mockery of logic and common sense that I had to read the original quote several times before I understood it.

Mississippi’s Republican governor, Phil Bryant, had this to say about the proposed law: “This legislation is an important step in strengthening abortion regulations and protecting the health and safety of women. As governor, I will continue to work to make Mississippi abortion-free.”

Wait a minute. First he wants to merely “strengthen” abortion regulations. But then he says he wants to “make Mississippi abortion-free.” That should convince anyone who wasn’t already convinced that this law has absolutely nothing to do with making sure that abortions are performed safely. Rather, it has everything to do with making Mississippi “abortion-free.”

That’s right, he didn’t even try to pretend this was about women’s safety.

In my opinion, the fact that criminalizing abortion leads to dangerous back-alley abortions is the strongest argument for keeping abortion legal. It’s the strongest argument because it doesn’t lean on emotion or ideology. We can argue left and right about when life begins and when fetuses feel pain and whether or not women have the right to choose what to do with their bodies (hint: yes), but we cannot argue with the preponderance of evidence that shows that criminalizing abortion does not prevent abortion. It merely makes it dangerous.

Pro-lifers’ continued refusal to accept this argument says one or both of these things about them:

1. They are unwilling or incapable of accepting and understanding basic facts about economics and decision-making. That is, despite all the evidence showing the negative consequences of the criminalization of abortion, these politicians (and voters) continue to believe that banning abortion would plunge us all into Fun Happy No-Killing-Babies Land.

2. They understand these facts, but just don’t care. This is undoubtedly the worse alternative, because it means that the pain, injury, and even potential death that will come to women who try to obtain illegal abortions are, to borrow from Shrek‘s Lord Farquad, a sacrifice that Republicans are willing to make.

So, ignorance or malice? Take your pick.