Joshua Coleman sat down with Pauline Boss to talk about her latest book, The Myth of Closure: Ambiguous Losses in a Time of Pandemic and Change.

Why did you write this book? I wrote it because I strongly believe there is no closure after the loss of someone you love. From my 40 plus years of working with ambiguous loss around the world, I learned about the myth of closure, people who love relatively well despite living with a loss that has no clarity or official verification. So, I wanted to write a book about this misuse of the term closure for some time.

I started this book several years ago, but then my husband required care and I set the manuscript aside. After he died in 2020 (of a stroke, not COVID), and the shutdown from COVID continued, I picked up the manuscript again and finished the book. What surprised me is that it’s now a very different book from the one I began writing several years ago. It is personal, it’s  about topics I never addressed before (personal ambiguous loss, racism, climate change). Importantly, it’s not a therapy book, but I hope it’s therapeutic– for whomever reads it, ordinary readers as well as professionals. After nearly two years of pandemic, political upheaval, and racial injustice and disparities, people are highly distressed, if not traumatized,  right now, and need help. This book does not pathologize or offer a medical model, but rather is more social psychological and a way of thinking that is stress based and meant to help us cope with this unprecedented time of trouble.

(1) Why is closure  a myth? Isn’t that what people want after loss?

Closure is a perfectly good word in real estate or when a road is closed after a flood, but it’s a hurtful word in human relationships. Using it after loss makes people think there will be an end to the pain, but in fact, we live with grief and don’t get over it. Of course, it is lessened over time, but we keep the lost person in our heart and mind. Closure is not necessary nor achievable. Often, it is a misnomer in that what people really yearned for which is clarity, certainty, or justice  about one’s loss. People want the certainty of loss, proof, justice  not closure.

(2) What is ambiguous loss and how does it differ from losses with a clear finality such as a validated death?

Ambiguous loss is an unclear loss that has no resolution. There are two kinds: Physical and psychological.  Examples of physical ambiguous loss are soldiers missing-in-action, children kidnapped, migrants who disappear, etc.  More common examples of physical ambiguous loss result from divorce and adoption.  The lost person is gone, but not for sure. There is no proof of death.

Psychological ambiguous loss results when the person is present, but their mind or memory is disappearing. Examples are Alzheimer’s disease the and the over 80 other illnesses or conditions that lead to dementia. The person is there but not there.

(3) What ambiguous losses have we experienced during the pandemic and how do they affect us?  Physically, we have lost the ability to touch those we love, to be with them in the hospital or care facility when they are ill or dying. Until recently, young people have been separated from friends and classmates, while rituals of life, such as weddings and funerals have been limited to just a few people or virtual events. Psychologically, we have lost trust in the world as a fair and safe place, we have lost our feelings of safety when out among the public, etc. The book goes into this more.  

(4) if the pandemic (or another crisis) forces us to adapt and change, is that a good thing?   Well, the pandemic is not a good thing, but learning to adapt and change is a good outcome to a bad situation.  It increases our resilience and our tolerance for ambiguity so we can better cope with other troubles that may come down the road. (5) And why might some people refuse to change and adapt to crises, (wear a mask, get vaccinated) while others adapt and change?  Some people remain absolute thinkers when the problem is ambiguous. The virus is invisible, the scientists understandably can’t talk in absolutes, the losses remain unclear– so if one is an absolute thinker, you pick an absolute answer to the trouble. In this case that means, “It’s a hoax, I don’t need to wear a mask, nor get vaccinated. It’s all about MY freedom, not my community.” Such absolute thinking is also evident when people say, “You’re either for me or against me;” “People are either dead or alive; there is no ambiguity,” so they declare a missing person dead prematurely and they don’t’ see the in between, the nuance.

The Council on Contemporary Families (CCF) seeks applicants for the CCF Scholars Early Career Program.  The CCF Scholars Early Career Program offers a unique professional development and mentorship opportunity to early-career scholars conducting research on American families. The program offers selected scholars mentorship from senior scholars who will provide them guidance and support to promote their research to journalists and the media.

Through participation in the CCF Scholars Early Career Program, early career scholars will attend a virtual summer-long program consisting of four professional development seminars and three one-on-one meetings with their mentors, including peer networking activities and training in public scholarship with other scholars. In the Fall, they will attend a special one-day event at Ohio State University to present their research to the board of CCF, meet their mentors in person, and receive further training, mentoring, and networking opportunities with board members and each other.

Each CCF Scholar will receive an allocation of $750 towards travel and complimentary CCF membership for two years. Scholars will also work to produce a research brief, fact sheet, or blog post about their research that CCF will publish and disseminate to the media. These experiences will enable scholars to gain valuable skills to promote their research on American families to media outlets and allow them to interact not only with their selected mentors but also with other scholars and professionals.

Eligibility

• Ph.D. completed by May 2022.
• Early career professional (i.e., doctoral degree granted within seven years or less, or current postdoc or assistant professor). Scholars from diverse disciplines are encouraged to apply. Current CCF members include demographers, economists, family therapists, historians, political scientists, psychologists, social workers, sociologists, communication scholars, as well as other family social scientists and practitioners.
• Research program is broadly consistent with the mission of CCF to enhance the national understanding of how and why contemporary American families are changing, what needs and challenges they face, and how these needs can best be met. 
• Has a draft of an unpublished manuscript that addresses an important problem, process, or issue in the science or practice of American families. Data should be analyzed, and manuscript should be in progress with plans to submit to a peer-reviewed journal.

To Apply

You must submit the following materials to the Council on Contemporary Families no later than April 8, 2022, by 11:59 p.m. PST:

• A one-page cover letter detailing why you are interested in the program, your research interests and experience, and career goals.
• An abstract of the manuscript in progress, including methods, results, and key findings, that will be the focus on the training in the program.
• A curriculum vitae (CV). 
• A letter of recommendation from a mid-career or senior scholar supporting your application for the position.  Recommenders may submit their letters of recommendation at the following link: https://forms.gle/CFFxH76MH1pnJCb69

Scholars will be selected in late April, and the program will begin at the end of May.  Additional information about CCF can be found at https://sites.utexas.edu/contemporaryfamilies/

Questions?  Please contact Dr. Noni Gaylord-Harden at ngaylord@tamu.edu

  Single people are often pressured to find a new partner in our “couple culture,” where the idea that some people might want to be single seems, to many, unthinkable. The benefits to (and limits of) monogamous relationships have long been critiqued by feminist scholars asserting that heteronormative coupling lacks mutual respect, desire, intimacy, and pleasure. Embedded in these critiques of human relationships is the notion that people want to be in relationships with one another. Perhaps, but for some people, after a second, third, or fourth divorce, they decide to single lives. How many major breakups would it take for you to decide that human relationships simply just aren’t for you?

In my research, I wanted to know why some people own what are usually called “sex dolls” (e.g., life-sized sex toys resembling a human person) and better understand how doll owners compare their sex practice to human sexual relationships. I conducted digital ethnographic fieldwork among the online love and sex doll subculture—a group of people who gather online to share with one another about the highs and lows of synthetic companionship. For 14 months spanning 2020 and 2021, I posted on message boards, hung out in chatrooms, followed dolls, doll owners, and doll companies on social media, and conducted interviews with 41 people. I met people living with synthetic companions living in North America, Europe, and Australia. My goal was to interview a diverse sample of doll community members, so I purposefully sampled men, women, and queer doll owners, the partners of doll owners, and people who work in the adult industry.

A common thread among doll owners is dissatisfaction with human relationships. Few doll owners are young and inexperienced. Rather, most doll owners are 40 years or older, have been in one or multiple long-term relationships, and after experiencing a particularly bad breakup, have chosen to move on from human relationships. It’s also true that the typical doll owner is a heterosexual man. These commonalities result in a culture that centers men’s experiences and desires. Some men expressly blame feminism and liberalism for their relationship woes and suggest that modern relationship expectations are unrealistic. Other men within the community actively resist this framing and do not blame women for their predicament. They simply prefer to be single. Nonetheless, what connects doll owners is desire for intimacy and sexual pleasure, just not with a human.

By no means do heterosexual men have a monopoly on intimate hardship. Women, queer, and trans people can also become tired of trying to find a relationship that meets their wants and needs. Although most dolls cater to heterosexual men, doll companies pride themselves on customizability and variety. As such, single people spanning a diverse spectrum of gender and sexual identities are beginning to find synthetic companionship attractive. For marginalized doll owners, the default masculine discourse of the doll community is off-putting, especially so for women, many of whom hope that the stigma associated with sex dolls will erode as more people chose synthetic companionship. One woman who is a content moderator for a prominent doll forum named Helen compared the stigma of synthetic companionship to the rights of sexual minorities. She said, “I think as more people buy dolls and more dolls are out there in the public eye, it will become more accepted. It’s a generational thing. Compare it to Stonewall, you know? Who would, who would imagine that after Stonewall, 30 years later, they would legalize gay marriage nationwide? I mean, that would be, that would have been unthinkable.”

Importantly, synthetic companionship is not restricted to single people. Dispersed among the community I also met people using dolls in ways that challenge heteronormative monogamy. Some couples use dolls to fulfill extramarital desires, while others leverage the customizable aspect of dolls to have sex in transgressive ways. Because genital configurations can be swapped with ease, queer doll owners use their dolls in ways that challenge normative understandings of gendered bodies and desires. For example, Sean, who is in a polyamorous marriage with his AFAB non-binary wife, purchased a doll to have a girlfriend. Additionally, since Sean also enjoys being anally penetrated during sex, he also bought a penis attachment that he can put onto his doll Gracie to change her sexual functionality.

As we advance further into the 21^st century it is likely that technology will continue to play an increasing role in sexuality and intimate relationships. Research on dating apps has exploded in recent years as more and more people use online dating to find partners. And while some attention has been paid to sex dolls, most of this research has been theoretical rather than empirical. Perhaps this is because few acknowledge that people are already living synthetic lives. But they are, and understanding how social forces shape the decision to forgo human relationships will be crucial in understanding this controversial sex practice.

Kenneth R. Hanson is a Doctoral Candidate in the University of Oregon Department of Sociology. He researches how and why people use technology to fulfill sexual and emotional desires, cultural narratives about sexual transgressions, and gendered sex practices. You can find him on Twitter @Ken_R_Hanson

Funding acknowledgements:

Lawrence Carter Graduate Student Research Award, University of Oregon Department of Sociology

Research Award for Data Collection and Presentation, University of Oregon Department of Sociology

Reprinted from the UT Austin Texas Population Center.

Introduction

For those wanting to end a pregnancy, the cost of in-clinic abortion care can be a significant barrier. The average cost of medication abortion (abortion with pills) in a clinic is $551. The majority of people pay for their abortion out of pocket. Abortion funds help cover some of the in-clinic abortion costs for some people, but they are not able to assist everyone in need of financial help. Many people who struggle to pay for their abortion delay or forgo paying bills such as rent, food, or utilities. The lack of affordable access to abortion care in the United States is linked to ongoing personal financial distress, debt, and poor credit.

Restrictive abortion laws in the U.S. add further economic burdens to people who would like to obtain an abortion in a clinic. At the federal level, the Hyde Amendment bans insurance plans that use federal funds, such as Medicaid, from paying for abortion care. Restrictions at the state level, such as mandatory waiting periods and multiple visit requirements, add costly appointments to the in-clinic experience. Restrictions aimed at abortion facilities, such as requiring that they be fitted out like mini-hospitals, have closed many clinics. These closures have placed additional financial burdens on people seeking in-clinic abortion care by necessitating out-of-pocket costs such as childcare, lodging, transportation, and lost wages. 

As abortion has become increasingly restricted, researchers have found evidence that some people in the U.S. forgo the clinic altogether. Instead, they manage their abortion on their own, outside of the formal healthcare setting. While some people have attempted abortion self-management with methods such as herbs, teas, homeopathic remedies, or self-harm, the growth of information-sharing on the internet has brought expanded access to the abortion medications mifepristone and misoprostol. 

In 2018, Aid Access became the first service to provide self-managed medication abortion in the U.S. via an online telemedicine service.

This brief reports on a recent study of 80 U.S.-based people who self-managed their abortion using medications obtained from Aid Access. The in-depth interviews, conducted anonymously, sought to understand the role that socioeconomic factors play in an individual’s decision to self-manage an abortion using online telemedicine.

Key Findings

• The main reason why participants sought abortion care via online telemedicine was the unaffordable cost of in-clinic abortion.
• Restrictive state abortion policies, on top of personal financial hardship, made it impossible for participants to access abortion care in a clinic.
• For participants with children, their family’s economic wellbeing motivated the decision both to seek an abortion and to do so via online telemedicine.
• Medication abortion provided via online telemedicine offered an affordable alternative to the high costs of in-clinic abortion care. However, for some, accessing pills at no cost or a reduced cost was necessary because the suggested donation of $90 still posed a financial burden. See representative quotes below.

The high costs of in-clinic abortion care, made more difficult by restrictive abortion policies – along with balancing the needs of existing children – motivated people to seek medication abortion via online telemedicine

Note: Quotes have been edited for brevity.

Policy Implications

To improve people’s access to abortion in the United States, particularly for those with low incomes, policymakers can make policy changes to improve the availability and affordability of telemedicine for medication abortion. They can also make policy changes to improve Medicaid and private insurance coverage for clinic-based abortion.

The Food and Drug Administration regulates the abortion medication mifepristone by a Risk Evaluation and Mitigation Strategy (REMS). This regulation requires that providers must register as certified prescribers and that mifepristone be dispensed directly from a healthcare facility, rather than a retail pharmacy. Despite a growing body of evidence demonstrating that the existing restrictions are medically unnecessary and overly burdensome, the REMS remains.

Removing the REMS classification would increase delivery of medication abortion. In the 31 states that do not ban the provision of abortion by telemedicine, providers could implement flexible service delivery models. Providers could conduct the pre-abortion appointment via telemedicine, and partner with mail-order pharmacies to ship the medications directly to the patient or allow for pick-up at a retail pharmacy. This would allow patients to reduce their trips to the clinic, especially in states with laws requiring multiple trips for pre-abortion ultrasounds or state-mandated counseling. Removing the REMS and making the medications available by mail or pharmacy pick-up would mean fewer trips to the clinic and alleviate some of the burdens such as paying for transportation, childcare, or taking time off of work.

In addition to removing the REMS, Congress could expand affordable abortion access by passing the Equal Access to Abortion Coverage in Health Insurance, or EACH Woman Act. This legislation would repeal the Hyde Amendment and ensure coverage for abortion through all government-sponsored health insurance plans. It would also prohibit politicians from interfering with private health insurance plans that offer coverage for abortion. This would substantially expand insurance coverage for abortion care and would increase the ability of more people, particularly people with low incomes, to obtain an abortion from a medical provider.

Evidence suggests that self-managed abortion will continue, especially as new abortion restrictions are enacted, such as Texas’ recent law prohibiting abortions at around six weeks’ gestation. For people living in the 19 states that prohibit the provision of abortion by telemedicine, self-managed abortion options are especially important.

However, potential legal risks exist for people who self-manage their abortion. Arizona, Oklahoma, Nevada, South Carolina and Delaware have all passed laws criminalizing self-managed abortion, and people in these states could be prosecuted.  Moreover, people with few economic resources or those who are members of groups historically criminalized in the U.S. may be at even greater risk of prosecution. Policymakers could eliminate these risks by repealing laws that criminalize self-managed abortion.

Reference

Johnson, D.M., Madera, M., Gomperts, R. & Aiken, A.R.A., The economic context of pursuing online medication abortion in the United States. (2021). SSM – Qualitative Research in Health. https://doi.org/10.1016/j.ssmqr.2021.100003.

Suggested Citation

Johnson, D.M., Madera, M., Gomperts, R. & Aiken, A.R.A. (2021). What motivates people in the United States to seek medication abortion pills outside of the clinic setting? PRC Research Brief 6(11). DOI: 10.15781/xm1d-t214.

About the Authors

Dana M. Johnson, danajohnson@utexas.edu is a PhD candidate in public policy and demography and an NICHD predoctoral trainee in the Population Research Center at The University of Texas.

Melissa Madera is a senior project manager and research fellow for Project SANA (The Self-Managed Abortion Needs Assessment Project).

Rebecca Gomperts is the founder and director of Women on Waves, Women on Web and Aid Access.

Abigail Aiken is an associate professor in the Lyndon B. Johnson School of Public Affairs and a PRC faculty scholar at The University of Texas at Austin.

Acknowledgements

This study was funded by the Society of Family Planning (SFP), Grant # SFPRF12-MA1 and received infrastructure support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Grant # P2CHD042849). Neither source of funding had any involvement in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Reposted with permission from the Gender & Society Blog

The COVID-19 pandemic has worsened inequalities in unpaid care work, with increased childcare and housework burdens disproportionately borne by women. Across Europe and North America, women have been pushed out of the labor market, while mothers are increasingly suffering from stress and burnout.

Social policy might be able to reverse these trends – and the Carework Network has been urging the Biden-Harris administration to take decisive action now and reinvest in care infrastructure to “build back better”. Similar campaigns have been launched internationally, including in Canada and the UK.

But what can data tell us about the potential for welfare programs to address the gender gap in unpaid care work?

In our recent article in Gender & Society, we quantify the connections between social policy spending and inequality amongst unpaid care workers across 29 European countries.

We find that social policies do matter in addressing women’s “double burden” (at home and in paid work). Spending on social policies targeted to families – i.e., child allowances and credits, childcare supports, parental leave supports, and single-parent payments – is associated with a smaller gender gap in time spent on housework. And while this dynamic is visible across the income spectrum, it is strongest in lower income households.

The Gendered and Classed Dimensions of Unpaid Care

Data from the 2007/2008 and 2016/2017 waves of the European Quality of Life Survey highlights the scope of the care crisis even before the onset of the pandemic.

Figure 1 presents the mean weekly number of hours spent on unpaid care, broken down by care type (i.e. childcare as compared to housework), gender, and income quartile, for people living with at least one child under the age of 18 years. Several patterns emerge.

First, across all income groups, childcare makes up the majority of time dedicated to unpaid care work. This means both men and women spend proportionately more time caring for children than cooking and cleaning.

Second, women devote around twice as much time to unpaid caring as men. This pattern is consistent across the income spectrum, though the gender gap is especially large in lower income households.

Third, women with higher household income spend less time on unpaid care work than their poorer counterparts – likely because wealthier women outsource work to paid care providers. Men, by contrast, dedicate similar (lower) amounts of time to unpaid care work regardless of income level.

Fourth, childcare makes up a larger proportion of unpaid care work for wealthier women than for poorer ones. This reinforces prior research on “intensive mothering”: time spent educating children has become an important means of class reproduction within higher-income families, while “menial” tasks such as cooking and cleaning are more readily outsourced.

Spending on Family Policy is Associated with Reduced Inequalities in Housework

Using national data from the Organisation for Economic Development and Co-operation’s SOCX database, we then examine the state’s potential role in reducing inequalities in unpaid care work.

Figure 2 illustrates the relationship between how much a country spends on helping families (as a percentage of GDP) and the mean number of total hours spent by women and men, per country, on housework.

The two panels highlight that the gender gap in unpaid housework is a common feature across each of the 29 countries we examine. Regardless of the country or level of spending, women continually perform more unpaid housework then men.

Yet the data also show that the more a country spends to help its families thrive, the fewer hours women spend on housework. Women in countries where money spent on families accounts for a higher proportion of GDP spend less time, on average, doing unpaid housework tasks.

Using Family Policy to Build Back Better

Our analyses show that while women – and especially poorer women – spend more time on unpaid care work than men, carefully designed social policy spending may help to shrink the size of that gender gap. For governments, then, (re)investing in social programs that target families offers a promising route forward to counteract the large increases in unpaid care work that have occurred during the pandemic. These programs should be a crucial component of post-pandemic efforts to create a more equitable and caring society.

Naomi Lightman is Assistant Professor of Sociology at the University of Calgary. Her current research focuses on the of impacts of the COVID-19 pandemic on the employment conditions and health and well-being of paid caregivers in long-term care settings. Her related research publications examine the intersections of gender, inequality, care work (paid and unpaid), and social policy. You can follow her on Twitter @naomilightman.

Anthony Kevins is Lecturer in Politics and International Studies at Loughborough University. His research centers around inequality, public opinion, and various social policy programs, often with a focus on labor market vulnerability. You can read more about his research on his website, which also includes non-paywalled, open-access copies of his published studies – and you can follow him on Twitter @avkevins.

Reprinted from the UT Austin Texas Population Center https://liberalarts.utexas.edu/prc/research/research-brief-series/2021-research-briefs/johnson-economics-medab.php

For those wanting to end a pregnancy, the cost of in-clinic abortion care can be a significant barrier. The average cost of medication abortion (abortion with pills) in a clinic is $551. The majority of people pay for their abortion out of pocket. Abortion funds help cover some of the in-clinic abortion costs for some people, but they are not able to assist everyone in need of financial help. Many people who struggle to pay for their abortion delay or forgo paying bills such as rent, food, or utilities. The lack of affordable access to abortion care in the United States is linked to ongoing personal financial distress, debt, and poor credit.

Restrictive abortion laws in the U.S. add further economic burdens to people who would like to obtain an abortion in a clinic. At the federal level, the Hyde Amendment bans insurance plans that use federal funds, such as Medicaid, from paying for abortion care. Restrictions at the state level, such as mandatory waiting periods and multiple visit requirements, add costly appointments to the in-clinic experience. Restrictions aimed at abortion facilities, such as requiring that they be fitted out like mini-hospitals, have closed many clinics. These closures have placed additional financial burdens on people seeking in-clinic abortion care by necessitating out-of-pocket costs such as childcare, lodging, transportation, and lost wages. 

As abortion has become increasingly restricted, researchers have found evidence that some people in the U.S. forgo the clinic altogether. Instead, they manage their abortion on their own, outside of the formal healthcare setting. While some people have attempted abortion self-management with methods such as herbs, teas, homeopathic remedies, or self-harm, the growth of information-sharing on the internet has brought expanded access to the abortion medications mifepristone and misoprostol. 

In 2018, Aid Access became the first service to provide self-managed medication abortion in the U.S. via an online telemedicine service.

This brief reports on a recent study of 80 U.S.-based people who self-managed their abortion using medications obtained from Aid Access. The in-depth interviews, conducted anonymously, sought to understand the role that socioeconomic factors play in an individual’s decision to self-manage an abortion using online telemedicine.

Key Findings

• The main reason why participants sought abortion care via online telemedicine was the unaffordable cost of in-clinic abortion.
• Restrictive state abortion policies, on top of personal financial hardship, made it impossible for participants to access abortion care in a clinic.
• For participants with children, their family’s economic wellbeing motivated the decision both to seek an abortion and to do so via online telemedicine.
• Medication abortion provided via online telemedicine offered an affordable alternative to the high costs of in-clinic abortion care. However, for some, accessing pills at no cost or a reduced cost was necessary because the suggested donation of $90 still posed a financial burden. See representative quotes below.

The high costs of in-clinic abortion care, made more difficult by restrictive abortion policies – along with balancing the needs of existing children – motivated people to seek medication abortion via online telemedicine

Note: Quotes have been edited for brevity.

Policy Implications

To improve people’s access to abortion in the United States, particularly for those with low incomes, policymakers can make policy changes to improve the availability and affordability of telemedicine for medication abortion. They can also make policy changes to improve Medicaid and private insurance coverage for clinic-based abortion.

The Food and Drug Administration regulates the abortion medication mifepristone by a Risk Evaluation and Mitigation Strategy (REMS). This regulation requires that providers must register as certified prescribers and that mifepristone be dispensed directly from a healthcare facility, rather than a retail pharmacy. Despite a growing body of evidence demonstrating that the existing restrictions are medically unnecessary and overly burdensome, the REMS remains.

Removing the REMS classification would increase delivery of medication abortion. In the 31 states that do not ban the provision of abortion by telemedicine, providers could implement flexible service delivery models. Providers could conduct the pre-abortion appointment via telemedicine, and partner with mail-order pharmacies to ship the medications directly to the patient or allow for pick-up at a retail pharmacy. This would allow patients to reduce their trips to the clinic, especially in states with laws requiring multiple trips for pre-abortion ultrasounds or state-mandated counseling. Removing the REMS and making the medications available by mail or pharmacy pick-up would mean fewer trips to the clinic and alleviate some of the burdens such as paying for transportation, childcare, or taking time off of work.

In addition to removing the REMS, Congress could expand affordable abortion access by passing the Equal Access to Abortion Coverage in Health Insurance, or EACH Woman Act. This legislation would repeal the Hyde Amendment and ensure coverage for abortion through all government-sponsored health insurance plans. It would also prohibit politicians from interfering with private health insurance plans that offer coverage for abortion. This would substantially expand insurance coverage for abortion care and would increase the ability of more people, particularly people with low incomes, to obtain an abortion from a medical provider.

Evidence suggests that self-managed abortion will continue, especially as new abortion restrictions are enacted, such as Texas’ recent law prohibiting abortions at around six weeks’ gestation. For people living in the 19 states that prohibit the provision of abortion by telemedicine, self-managed abortion options are especially important.

However, potential legal risks exist for people who self-manage their abortion. Arizona, Oklahoma, Nevada, South Carolina and Delaware have all passed laws criminalizing self-managed abortion, and people in these states could be prosecuted.  Moreover, people with few economic resources or those who are members of groups historically criminalized in the U.S. may be at even greater risk of prosecution. Policymakers could eliminate these risks by repealing laws that criminalize self-managed abortion.

Reference

Johnson, D.M., Madera, M., Gomperts, R. & Aiken, A.R.A., The economic context of pursuing online medication abortion in the United States. (2021). SSM – Qualitative Research in Health. https://doi.org/10.1016/j.ssmqr.2021.100003.

Suggested Citation

Johnson, D.M., Madera, M., Gomperts, R. & Aiken, A.R.A. (2021). What motivates people in the United States to seek medication abortion pills outside of the clinic setting? PRC Research Brief 6(11). DOI: 10.15781/xm1d-t214.

About the Authors

Dana M. Johnson, danajohnson@utexas.edu is a PhD candidate in public policy and demography and an NICHD predoctoral trainee in the Population Research Center at The University of Texas; Melissa Madera is a senior project manager and research fellow for Project SANA (The Self-Managed Abortion Needs Assessment Project); Rebecca Gomperts is the founder and director of Women on Waves, Women on Web and Aid Access; and Abigail Aiken is an associate professor in the Lyndon B. Johnson School of Public Affairs and a PRC faculty scholar at The University of Texas at Austin.

Acknowledgements

This study was funded by the Society of Family Planning (SFP), Grant # SFPRF12-MA1 and received infrastructure support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Grant # P2CHD042849). Neither source of funding had any involvement in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

In the 1950s, dating etiquette decreed that the man had to initiate all interactions. Although much has changed since then, many women continue to believe they will end up with a higher quality man if they don’t appear too eager. You might think the tech savvy women who turn to the internet to search for partners would be less inhibited, but in a recent study using 6 months of online dating data from a midsized Southwestern city (N=8,259 men, 6,274 women), my coauthors and I found that women send 4 times fewer messages than men.

But the payoffs for violating older gender conventions are significant. A woman who initiates a contact is twice as likely to get a favorable response from a potential partner as a man who does so. And women who take the initiative connect with equally desirable partners as women who wait to be asked, without having to wade through a pile of less desirable suitors.

University of Texas sociologist Shannon Cavanagh studies online dating and analyzes hundreds of thousands of messages between partners.

Originally printed February 11, 2015 https://thesocietypages.org/ccf/2015/02/11/hoping-for-a-valentines-day-date-stop-waiting-to-be-asked/

Breaking up takes skills: Do you have them?                                

Reposted with permission from Psychology Today

Research from the ’80s and ’90s taught us that breakups are often a painfully long process, marked by fits and starts, internal debate, and lots of negotiating with your partner. One study found that it took 16 steps to break up with someone. On the other end of that spectrum is ghosting. If the relationship is casual enough, we can just stop communicating and the relationship dies quietly.

We know there is a middle ground between these two where, even in an uncomfortable breakup situation, people can go their separate ways with a bit of dignity left intact. Research shows that this process takes a set of breakup skills that no one really teaches us.

Both our culture and relationship research teach us that relationships take work to make them last. But what relationships are worth working for? What kind of work is healthy and necessary? And maybe most importantly: How do you know when to stop working at it?

In our study, we didn’t propose answers to those questions. However, with my colleague Dr. Jonathon Beckmeyer in the lead, we decided to explore what it takes to successfully break up with someone. This is what we found.

1. Know when to break up.

Dr. Beckmeyer and I have spent most of our careers studying emerging adults—or people ages 18-29 that are still figuring out who they are, what careers they want, and what education to pursue. They usually feel like they are somewhere in between adolescence and adulthood, and the world seems full of possibilities for them.

During emerging adulthood, people also explore their options for relationships. Research suggests that they must figure out how to coordinate their love lives around their education and career plans. If you’re in this age group and unmarried, this juggling act might sound familiar.

Aside from the more obvious reasons to break up (e.g., physical, emotional, or sexual abuse), it is important to assess whether your relationship is compatible with your individual goals. Does your relationship present barriers to you finishing school or taking a job you need or want? Do you feel supported by your partner as you pursue your goals? Does your partner want to live a similar kind of life to you in terms of work and family balance, having children, and geographic location?

These questions are especially important for emerging adults. If you’re in a relationship that is happy, healthy, and supportive, you can work together to make sure each of your goals is being met. If not, it may be time to move on.

2. Follow through on the breakup.

Breaking up with someone can be stressful, especially if you have been together for a long time. Unfortunately, if you aren’t clear and direct when breaking up with someone, they may end up confused about the status of the relationship. In this case, the breakup might drag on and on or you end up sliding back into the relationship.

Whether your breakup style is more self-focused (how does this affect me?) or other-focused (how can I ease their discomfort?) being clear about your intentions to end the relationship serves everyone’s interests. You get out of the relationship and they are not left wondering what happened.

3. If your partner wants to break up with you, accept it and move on.

Let’s imagine you’re on the other side of the breakup. Your job is to accept your partner’s wishes. You may disagree with their reasons for ending the relationship, but you can’t disagree with the breakup itself.

Truly accepting the breakup might also mean severing the ties you have to that person on social media. Research suggests that staying connected is likely to cause additional stress, anger, and pain. It also keeps you psychologically invested in their lives, which prevents you from moving forward separately from them. This kind of rumination has also been linked to more distress after a breakup.

If you really think the relationship still has potential, consider the old wisdom from Khalil Gibran, “If you really love somebody, let them go, for if they return, they were always yours. And if they don’t, they never were.” The key is that you have to honestly let them go.

4. Don’t delay the breakup.

Once you know the relationship is unhealthy or unsatisfying, just end it. In another study, we explored what happens when people linger in unsatisfying relationships for too long. In hindsight, the people we interviewed were full of regret that they hadn’t ended the relationships earlier. They felt stuck, but they had trouble overcoming the barriers they saw to leave the relationship, whether that was living together, being enmeshed with their partner’s family, or having children together.

We were surprised to find that sometimes unexpected events like the death of a family member or a diagnosis with serious illness delayed breakups because individuals felt obligated to see their partners through a difficult time. There is certainly room for kindness and consideration about the timing of a breakup, but there is unlikely to be a good time to end a relationship. When it’s time to move on, don’t delay.

Conclusion

Breakups can be painful and difficult, whether you are the “leaver” or the “left.” However, they are also a normative part of being a young adult. Leaving a relationship that isn’t working (or accepting when someone wants to end a relationship with you) helps you move toward the kinds of partnerships you truly want. The key is to try and learn from the experience so that the next relationship you form is stronger and more satisfying.

References

Beckmeyer, J. J., & Jamison, T. B. (2019) Is breaking up hard to do? Exploring emerging adults’ beliefs about their abilities to end romantic relationships. Family Relations. Advance Online. doi.org/10.1111/fare.12404

Jamison, T. B., & Beckmeyer, J. J. (2021) Feeling stuck: Exploring the development of felt constraint in romantic relationships, Family Relations, 70(3) 880-895. https://doi.org/10.1111/fare.12496

Tyler Jamison, Ph.D., is an Associate Professor of Human Development and Family Studies at the University of New Hampshire. Twitter: @DrTylerJamison

A therapist colleague got a call in the middle of the night from a mom in his practice.  The woman was frantic.  Her daughter’s anger had escalated into physical attacks.  The mother had locked herself in her room – not knowing who to call.  The friend asked me if I could recommend resources that he could give the family.  He was familiar with my research and new book “Difficult: Mothering Challenging Adult Children through Conflict and Change” which will launch on February 2^nd, Rowman & Littlefield. 

Difficult is the first book to speak to and name the experience of older mothers of troubled adult children who have become the default safety-net in the face of a failed mental health system, limited substance abuse treatment, and sky-rocketing rents.  Little known face – the most likely perpetrator of what is called elder abuse is a dependent adult child living at home suffering with mental illness and/or substance use disorder.  Vulnerable adults who cannot manage, or afford to, live on their own turn to their families.  But the shared household arrangement often only benefits the adult child.  Most cases of elder abuse do not get reported in part because older parents do not want their troubled adult children to go to jail.

My work is based on several years of qualitative research with older women (all over 60) who self-identified as having adult children whose problems were negatively impacting their quality of life.  After analyzing their stories, I coined the name “difficult adult child” to capture the dilemmas that each of the women reported about the complex difficult mothering that emerged for them when their adult child who had returned home because they could no longer support themselves. The older mothers (and fathers if available) do not feel appreciated for the sacrifices they are making by re-opening their homes to their children later in life. Each mother shared with me her feelings of helplessness regarding the conflict whose needs take priority – mine or hers?   

While this book will be extremely helpful to therapists and physicians who often do not sufficiently understand the stress that older parents with difficult adult children experience, Difficult is also written for the parents of challenging adult children.  There are chapters on mental illness, substance use and family violence that offer accessible psycho-education and resources for getting help.  This is a book you can suggest to your clients. It will help them see that they are not alone. 

So many families who have adult children who are “off-time” in their development and/or engaged in deviant or stigmatized behavior, keep their adult children’s troubles secret and often blame themselves.  The book is empathic to the terrible conflicts that parents feel when their adult child’s life is stopped by mental illness and/or substance abuse problems.   Beyond allowing mothers and fathers to feel less alone, there are several chapters that offer readers a way to use the Stages of Change model applied to changingtheir  relationship with an adult child; and there is a large section devoted to resources for self-care, getting social support, and staying safe. 

  Difficult is not about “boomerang kids” who will bounce back into independent living.  Instead, the book shines a light on a large, usually unseen, population of parents who often feel that their adult children’s problems have no solution.  The book presents the deep feeling of being “torn in two” that each woman is living with.  Each felt that she had no choice but to support her adult child when they were in crisis and had invited them to move back into the family home.  As clinicians, helping women see their problem as connected to other mothers and not a result of their unique failure in parenting can be empowering. 

The book can be ordered on-line from your favorite on-line book seller.

Judith R. Smith, PhD, LCSW, is a senior clinical social worker, therapist, researcher, and professor at Fordham University. She is a leader in gerontological research focusing on women’s experiences as they age. Her book, “Difficult: Mothering Challenging Adult Children through Conflict and Change” Rowman & Littlefield, will be available Feb. 2022.  Follow them on Twitter @JudithRSmithPhd

Reposted with Permission from the Gender & Society Blog.

“Um to me, being a Black girl is fighting the stereotypes that people have, like about all of us being loud and obnoxious, ghetto, ratchet, promiscuous, and all that.”

Following a Saturday morning arts-based workshop with Deborah, Christa, Unique, Philippi, and Nicole (self-designated pseudonyms), I interviewed girls about their workshop experience. I was also eager to learn about how they defined Black girlhood. Sitting upright in her seat, looking up at the ceiling and then eventually lowering her gaze to meet mine, Unique candidly shared her thoughts. She expressed frustration that despite being smart, serious about her education, and performing an unproblematic comportment, she felt unseen and overshadowed by the negative stereotypes. While it could prove useful to examine the racialized characteristics and the larger archetypes they support—like the thot, welfare queen, hood rat, and even older relics like the jezebel— it is also essential  to hear the reality that fighting is quotidian to being a Black girl.

When a Black girl is bullied and forced to choose between uninterrupted education and self-definition a fight follows. For example, when a Black girl is invited to the front of the room only to be sent back to her seat in tears with a braid missing or denied the experience of taking yearbook photos or required to remove beads in the middle of a game, a fight follows. As anti-Blackness and racialized expectations of femininity converge with loose and subjective interpretations of policies and regulations, Black girls must decide with whom or what they want to brawl. Although frequently attached to girls at each other’s throats, this truism is evidence of how Black girls’ embodiment is marked problematic, something to be policed, a reason for her confinement.

IN WHAT WAYS IS JUSTICE INTIMATELY TIED TO EXPRESSION AND SELF-DEFINITION?

“I understand hair clips and stuff that’s like on my forehead and stuff. I understand that, cuz it applies to everybody. But ask yourself, who else wears beads? Who else wears things that hang off braids in your hair?”

On April 19, 2021, high school sophomore and softball player Nicole Pyles became the target of anti-Black and gendered microaggressions. After playing a full inning and hitting a double, her beads were suddenly an issue. Nicole’s teammates collaborated to use some bands to secure the beads, and she tucked them into her sports bra. Allowed to return to the field, she helped her team strike out their opponent until it was her turn at bat.

In Nicole’s statement during an interview with The News & Observer, she made plain that the decision to label her hair a problem at this particular moment was both unethical and unnecessary. In addition to playing the first inning of the game on April 19, Nicole had played the first four games of the tournament with no issue.

The coach of the opposing team first brought attention to her hair, claiming it obstructed her jersey number, and then an umpire gave Nicole the ultimatum to remove the beads or sit out of the game. To Nicole, these were fighting words. Appalled by the demand and aware that the call wasn’t really about following a rule, she firmly and candidly communicated, “And so I made the decision that I was gonna remove my beads and I was gonna play my game.” The groundedness of Nicole’s deliberation can be understood as a transgressive act, one wherein a boundary is crossed in the name of a benefit, a desire, and in this case, an insistence on doing what she came to do: play (and win) her game.

Only the opposing team’s coach knows his true motivations for rigidly enforcing the rules at that particular moment. However, it would not be the first time a Black girls’ adornment or expression of self has rattled others, nor the first injustice endured due to hair stylization. They changed the game on Nicole. Under pressure from the other team’s coach, the umpire decided to invoke the code, placing full responsibility and blame on Nicole and her coach in the final hour of the tournament. Perhaps they bet on her having a different response to their push, that she would get rightfully indignant, loud, or disheveled. Being a Black girl requires us to choose our opponents carefully. Nicole decided to place her undivided attention on the game and fight her battle off the field.

WHAT DO BLACK GIRLS’ DELIBERATIONS ABOUT THEIR BODIES TEACH US?

In the face of varying textures of injustice, Black girls are inviting us to practice reliability. While there was no physical altercation on the field, the restriction of beads in the rules and the after-the-fact argument that her number was covered by her hair revealed the foul play afoot.

From over a decade of work with Black girls, reliability emerged as a pedagogy and tenet, a way to represent Black girls and the lessons they gift. Returning to Unique’s statement about fighting stereotypes and Black girlhood, to practice reliability with Black girls requires that their self-definition is welcomed. It is to ensure that rules and policies involving their livelihood are based on actual concerns of harm. To practice Black girl reliability in Nicole’s case would have meant breaking out into the game ‘Little Sally Walker’ cheering, “Gon’ girl, do yo thang, do yo thang, do yo thang, switch,” because she was on her game and her beads weren’t bothering nobody.

It would have meant leaving her be and believing in Nicole’s assessment of potential injury, her hair, and the game she came to win and wanted to play. When we say Black girls’ names, let it be in exaltation. Black girls everywhere are demanding that we see the injustice in denying their flavor, especially in spaces where they aren’t expected to be or shine. It’s up to all of us to listen.

Read Hill’s piece in the #SayHerName symposium here.

Dominique C. Hill, PhD, is a Blackqueer feminist whose written and performed scholarship interrogates Black embodiment with foci in girlhood, education, and artistic expression. Hill, in research and praxis, seeks to extend the field of Black girlhood studies as an assistant professor of Women’s Studies at Colgate University.