ACLU Lawyer Gillian Thomas’s book, Because of Sex, demonstrates that once a law is passed, the work has just begun. Thomas traces fifty years of court cases that interpreted the meaning of sex discrimination as established by Title VII of the 1964 Civil Rights Act. Thomas grips her reader from the start, opening the book with the controversial introduction of “sex” into the Civil Rights Act by Howard Smith (Democratic Representative from Virginia). To this day, scholars debate whether this addition was a sincere attempt to promote gender equality or a sexist joke aimed at derailing the Act. Ultimately, the clause stayed in and the Civil Rights Act passed prohibiting discrimination because of race, color, religion, national origin, and sex. However, as Thomas and other scholars have pointed out, because “sex” was a last minute addition to the law, its meaning received little attention from Congress. Therefore, it has been up to the courts to interpret what sex discrimination looks like. This is where Thomas spends the majority of her book.

Thomas argues that Title VII has led to “revolutionary” legal and cultural change and consequently “transforming what it means to be a woman who works” (p. 229). Each chapter of Because of Sex tackles one court case that made its way to the Supreme Court and set precedent for the interpretation of sex discrimination in employment. This case study approach allows Thomas to introduce her readers to all the players involved in each of these cases, giving background and historical contextual information that brings each case to life. For example, I’m very familiar with Price Waterhouse v. Hopkins, wherein sex stereotyping was ruled sex discrimination after Ann Hopkins was denied partnership for her management style and told to go to charm school. What I didn’t know was that after winning her case, Hopkins was offered $1 million to NOT return to work at Price Waterhouse. Hopkins turned them down and rejoined the firm after fighting them in the courts for nearly a decade. According to Thomas, Hopkins became a fierce advocate for diversity in the firm, which explains in part why now you can see Price Waterhouse on top lists of workplaces promoting diversity. What really hit home for me was how long these landmark cases take and how life moves on for the plaintiffs in the meantime. Their names may go down in legal precedent and/or history books for changing the direction of sex discrimination law, but in the meantime, they have to pay the bills. And as someone suing for employment discrimination, that isn’t always easy.

This is a book that fellow wonkettes may pick up for a quick and informative read. It may not be a book for academics looking to cite new research. Thomas does not situate her book within a larger literature, her argument lacks a theoretical or empirical contribution, and her methodology of choosing which cases to analyze is unclear. However, Thomas writes with a narrative style that makes reading legal cases accessible and enjoyable.   Let’s face it – reading about the law can be quite dry and boring even to those of us who are sincerely invested in its nuances, idiosyncrasies, and possibilities. Thomas uses her legal expertise and experience to translate the law for everyday readers. I especially appreciated how she threw in important procedural details to those of us who do not practice law. For example, she shows how a case moves from a district court, to an appeals court, and, if their petition is accepted, to the Supreme Court. Once at the Supreme Court, Thomas explains that there is no trial. Instead, each side’s lawyer has thirty minutes to present their argument and it is expected for the justices to jump in immediately and ask questions. Therefore, lawyers typically practice their argument through moot courts or assemblies of their peers, anticipating the questions justices may ask.

Because of Sex would also be a great supplementary text in college courses. For instance, I can imagine assigning sections of it in a Gender and Work course to help my students understand the various forms of sex discrimination. In my experience, the only form of sex discrimination college students know about is wage inequality. The case studies in Thomas’s book provide clear illustrations that sex discrimination can also involve denying employment to mothers, height and weight restrictions, discriminatory pension plans and leave policies, sexual harassment, and sex stereotyping in promotion decisions.   Thomas’s book could also pair well with legal mobilization literature, providing tangible examples of how people consider their legal rights, the various actors involved in advocacy, and how legal cases connection to larger social movements.

Because of Sex by Gillian Thomas is a good introductory text for folks looking to explore how courts have interpreted sex discrimination since its introduction to the Civil Rights Act.

Two new books have recently come onto my radar, both too good not to share.

The first is by Jo Paoletti, Associate Professor of American Studies at University of Maryland, and is titled Sex and Unisex: Fashion, Feminism, and the Sexual Revolution. I’ve been a fan of Jo’s since reading (and rereading) her previous and excellent book, Pink and Blue: Telling the Boys from the Girls in America. Here’s more about her new one, published by Indiana University Press, and now available:

Notorious as much for its fashion as for its music, the 1960s and 1970s produced provocative fashion trends that reflected the rising wave of gender politics and the sexual revolution. In an era when gender stereotypes were questioned and dismantled, and when the feminist and gay rights movements were gaining momentum and a voice, the fashion industry responded in kind. Designers from Paris to Hollywood imagined a future of equality and androgyny. The unisex movement affected all ages, with adult fashions trickling down to school-aged children and clothing for infants. Between 1965 and 1975, girls and women began wearing pants to school; boys enjoyed a brief “peacock revolution,” sporting bold colors and patterns; and legal battles were fought over hair style and length. However, with the advent of Diane Von Furstenberg’s wrap dress and the launch of Victoria’s Secret, by the mid-1980s, unisex styles were nearly completely abandoned. Jo B. Paoletti traces the trajectory of unisex fashion against the backdrop of the popular issues of the day—from contraception access to girls’ participation in sports. Combing mass-market catalogs, newspaper and magazine articles, cartoons, and trade publications for signs of the fashion debates, Paoletti provides a multigenerational study of the “white space” between (or beyond) masculine and feminine.

You can read more about Jo’s work on “gender mystique” at her website, www.pinkisforboys.com.

The second is an anthology edited by my pal and former Girl w/Pen blogger Shira Tarrant, Associate Professor of Women’s, Gender, and Sexuality Studies at California State University, Long Beach.  Gender, Sex, and Politics: In the Streets and Between the Sheets in the 21st Century (Routledge July 2015) isn’t available yet, but you can sign up here on Amazon to get notified when it is. Here’s a descript:

Gender, Sex, and Politics: In the Streets and Between the Sheets in the 21st Century includes twenty-seven chapters organized into five sections: Gender, Sexuality and Social Control; Pornography; Sex and Social Media; Dating, Desire, and the Politics of Hooking Up; and Issues in Sexual Pleasure and Safety. This anthology presents these topics using a point-counterpoint-different point framework. Its arguments and perspectives do not pit writers against each other in a binary pro/con debate format. Instead, a variety of views are juxtaposed to encourage critical thinking and robust conversation. This framework enables readers to assess the strengths and shortcomings of conflicting ideas. The chapters are organized in a way that will challenge cherished beliefs and hone both academic and personal insight. Gender, Sex, and Politics is ideal for sparking debates in intro to women’s and gender studies, sexuality, and gender courses.

 Happy reading, Penners!

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Looking ahead to Mother’s Day and Father’s Day, I encourage readers to check out Chloe Bird‘s latest post for The RAND Blog. In “Assessing and Addressing Women’s Health and Health Care,” Bird explains the knowledge gaps and emphasizes the benefits of changing our approach to health research:

Gender-stratified research can produce more effective decision tools and interventions, and in turn improve both women’s and men’s health and health care.

I have featured her work on women’s cardiovascular health in a past post: it’s an excellent example of why we need to pay attention to sex/gender differences when aiming to improve health care.  Bird cautions of the dangers of failing to make the necessary revisions:

Until access, quality, and outcomes of care are tracked by gender, inequity in treatment will remain invisible and consequently intractable.

As we move forward with the Affordable Care Act, it is important to pay attention to the new assessments and tracking of the quality of care.  In the words of Bird, “This tracking should take gender into account so that disparities in health care and outcomes become visible and get the attention they deserve.”

Valentine’s Day is not the only reason to think about hearts in February, a.k.a. American Heart Month.  This guest-post on women’s heart health by Chloe E. Bird, Ph.D. — senior sociologist at the nonprofit, nonpartisan RAND Corporation and professor at the Pardee RAND Graduate School — discusses findings from a recent RAND pilot study.*  In our email exchange, Chloe emphasized, “…please don’t assume that you, or the women in your life, are too young to be concerned.”

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High-quality routine care for both cardiovascular disease (CVD) and diabetes is at least as relevant to women’s health and survival as it is to men’s.  Yet evidence suggests that women continue to face gaps in even low-cost, routine aspects of care.

CVD is the leading cause of death for women, as well as for men. More than one in three adult women has some form of CVD.  In fact, since 1984, more U.S. women than men have died of CVD, and 26 percent of women over age 45 die within a year of having a recognized heart attack, compared with 19 percent of men. Diabetes is a major cardiovascular risk factor, and it increases risk of CVD more so in women than in men.

Despite improvements over recent decades in care for CVD and diabetes, evidence suggests that the care women receive—and their health outcomes—continue to lag behind those of men, even for routine care such as monitoring and control of cholesterol. Although the American Heart Association’s “Go Red for Women” campaign and efforts by Sister-to-Sister and WomenHeart have done much to raise awareness among both women and their clinicians about CVD, there is still too little attention devoted to preventing heart disease in women.

Part of the problem is that quality of care is not routinely measured and reported by gender. Conventional methods of measuring quality of care focus on average “quality performance scores” across the overall population. Separate assessments and reporting by gender are rare, so the care received by women is generally assumed to be equal to that received by men, despite evidence to the contrary. As a result, the quality gap in care remains largely invisible to individual women, providers, payers and policymakers, even among those seeking to improve women’s health and health care. In cases where gender gaps in care have been monitored and targeted, such as in recent initiatives by the Veterans Health Administration, marked reductions in gender disparities in CVD and other types of care have been achieved; though some gaps persist.

In an examination of gender gaps in cholesterol screening among adults in one large California health plan who had been diagnosed with CVD or with diabetes, we found larger gender differences on average in care for CVD (5 percentage points) than for diabetes (2 percentage points). Although the gaps may appear small among the 30,000 CVD patients and 155,000 diabetes patients whose care we examined, they translate into a significant number of women who were not screened, but who might have been had they been men.

We focused on screening because clinicians agree that CVD and diabetes patients should receive annual screenings for high LDL cholesterol.  Such screening is also the first step in assessing quality of care.  Moreover, research on disparities in care often finds that gaps in screening are associated with larger gaps in treatment and poorer intermediate outcomes.

In our study, gender gaps in cholesterol screening varied geographically and favored men far more often than women. Among CVD patients, there were gaps favoring men in 79 percent of counties. In 35 percent of counties, those gaps were moderate (from 5 to less than 10 percentage points) or large (at least 10 percentage points). In 12 percent of the counties there were small gaps (from 1 to less than 5 percentage points) favoring women. Among patients with diabetes, which has not traditionally been viewed as a man’s disease, there were moderate gaps favoring men in 17 percent of counties and small gaps favoring men in another 40 percent of counties. In contrast, there were large gaps favoring women in 4 percent of counties, moderate gaps in 2 percent, and small gaps in another 12 percent.

Lessons from areas with the highest quality of care and from areas with the fewest gender disparities can motivate efforts to improve care and reduce disparities. Mapping quality of care at specific geographic levels and focusing on the areas of interest to specific stakeholders may prove to be essential to efforts to tackle disparities efficiently and meaningfully.

Without gender-stratified reporting of quality of care, gender gaps are invisible and intractable. Such reporting is essential if health plans, health care organizations, and policymakers are to ensure that overall improvements in care narrow gender gaps.

Health plans should use gender-based analysis and mapping to address gender gaps and to motivate improvements in care, treatment and outcome measures. Similarly, analyses of pooled data from multiple health plans could be used to assess gender disparities in care for CVD and diabetes for managed care patients and determine whether the size and patterns of disparities differ across plans.

Closing the gender gap is crucial if women are to benefit equally from improvements in care for CVD and diabetes.  At the same time, focusing on gender gaps can inform a broader discussion of the prevalence and burden of CVD in women and the need for improvements in prevention, diagnosis and treatment.

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*For more information, check out the online report and videos of her presentation and other researchers’ talks from RAND and UCLA’s recent women’s heart health event.

New controversy about free condoms inspires this month’s column, a critique about student health and public health by Chloe E. Bird, Ph.D., senior sociologist at the nonprofit, nonpartisan RAND Corporation and co-author of Gender and Health: The Effects of Constrained Choices and Social Policies (Cambridge University Press).

Last month, the CDC released a report that I’m going to pick on a little bit, though I’ve seen numerous researchers make similar faux pas in surveys I’ve taken and studies I’ve read.  The report, Sexual Behavior, Sexual Attraction, and Sexual Identity in the United States, uses data from the 2006-2008 National Survey of Family Growth to summarize findings on these topics.  I’m just going to harp on a tiny bit of the survey design, because I think it’s illustrative of a broader point about how survey design can reflect and even shape attitudes about what is and isn’t a sex act, and what is and isn’t a sexual relationship.

Now, to be fair, the NSFG is primarily about addressing things like pregnancy, marriage, and STIs.  The portion of the survey that focuses on sexual acts includes same-sex partners but it’s still geared towards things like STI risk, and thus focuses on sex acts that have a high STI risk like penetration and oral sex.  But there’s still a big problem in the way it describes the possible sex acts for males and females.

Note: The portion below the cut may not be safe for work due to frank descriptions of sexual acts.

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