On this historic day, the US Supreme Court’s ruling on health care is being hailed as “a victory for all Americans” – but will all Americans benefit equally from the new health care law signed into law by President Barack Obama? No, not those, like Obama, who are male.

The ACA’s list of “Covered Preventive Services for Adults” includes screenings for only two sexually transmitted infections (STIs): “HIV screening for all adults at higher risk” and “Syphilis screening for all adults at higher risk.” They do include “Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk,” and “Immunization” for the STIs Hepatitis B, Herpes and Human Papillomavirus (HPV). All sexually active boys and men are potentially at risk for contracting a wide range of STIs, including HIV: the interpretation of “higher risk” could keep many from receiving necessary care.

If you scroll down this page, you’ll find the longer list of “Covered Preventive Services for Women” which includes additional sexual and reproductive health care screenings related to breast cancer, cervical cancer, chlamydia, contraception, gonorrhea, plus extra screenings HIV and HPV.  This laudable list is capped off by “Well-woman visits” described as, “preventive care visit annually for adult women to obtain the recommended preventive services that are age and developmentally appropriate….” Why would a man not benefit from these types of services?

A google search for “well-man visits” turns up nothing on U.S. government websites and only one company’s description of their “Well Man Examination” policy: it includes only “Digital rectal exam; and Screening PSA test (age 40 or older).” Younger men could benefit from an examination for testicular cancer, “the most common cancer in American males between the ages of 15 and 34.” None of these tests are mandated under the ACA.

Looking again at government resources, the inequity jarring. In addition to having a website devoted to National Women’s Health Week in May, the U.S. Department of Health and Human Services also sponsors an Office on Women’s Health website.  If you’re on the homepage of the U.S. Department of Health and Human Services and search for “men’s health” you will not find a men’s health website.  However, their Office on Women’s Health website (somewhat ironically) features the U.S. government’s only resource webpage for men’s health, including a link to men’s sexual health. On this page, it focuses more on aging and sexual dysfunction, with only one small link to sexually transmitted infections. This “sexual health” page seems to patronize and condescend to men, doubting their abilities to care about and seek sexual health care:

“Sexual health is a source of concern for many men. Yet some men are not comfortable talking to their doctors about sex.” And, later on, “Remember that problems with sexual health are medical problems, and your doctor can help.”

If you live in King County, WA, then you might be in luck: their Public Health website features a fairly detailed description of “physical examinations for men.”  If you don’t feel comfortable seeking these examinations from your regular doctor, then check out Planned Parenthood: a national organization that provides men’s sexual health exams. While I’m not sure how many U.S. teen boys and men would think of Planned Parenthood clinics as their home base for sexual health care, U.S. health policymakers should look to them for guidance. Depending on the specific PP clinic, their services might include:

• checkups for reproductive or sexual health problems
• colon cancer screening
• erectile dysfunction services, including education, exams, treatment, and referral
• jock itch exam and treatment
• male infertility screening and referral
• premature ejaculation services, including education, exams, treatment, and referral
• routine physical exams
• testicular cancer screenings
• prostate cancer screenings
• urinary tract infections testing and treatment
• vasectomy

U.S. men, where is your outrage? Where are the protests demanding equality in sexual and reproductive health services? Why is there no U.S. Office on Men’s Health? A little digging online unearthed the failed “Men’s Health Act of 2001” which articulated the need for an Office of Men’s Health. If this act is not a priority for today’s politicians, then I encourage you to do your part to raise awareness about the need for accessible, affordable and comprehensive men’s sexual and reproductive health care. All of us — men, women and children — will benefit from better men’s sexual health.

Along with thousands of other travelers, I flew home today from Oklahoma City.

Unlike them, I wasn’t visiting for the NBA finals.

I flew to Oklahoma a week ago to help my mom with my 86-year-old father, who fell over Memorial Day weekend and fractured a vertebra. After a several-day stay in the hospital, he was sent to a rehabilitation center so that he could participate in intensive therapies—physical, occupational, and speech. Since he injured himself and entered the hospital, he has lost most of his ability to walk (because of his back brace, plus atrophying muscles), talk (weak vocal cords), and put on his glasses (weak motor control). Fortunately he is lucid, and his physical condition has been improving.

Nevertheless, this sudden turn of events has been very hard on my mother, who’s only a few years younger than he is. There’s a lot to do, much of it stressful. For the past week, we’ve been visiting my father, tracking down nurses and doctors and therapists, meeting with care managers and lawyers and neighbors, visiting other facilities, and talking to insurance companies.

It all gives a new meaning to the name of this column, “global mama,” when you think about it a bit more expansively and in terms of long-distance caregiving. Which is probably one of the reasons I’ve always been drawn to issues such as transnational mothering in the first place.

I live in New York. My elderly parents and my younger sister, a 40-year-old woman with Down syndrome, live in Oklahoma. And she’s not getting any younger, either.

My mom is the primary caregiver for my father right now. But his recent fall and my trip have started me thinking about a lot of things. About the fact that my aging mother is caring for an increasingly infirm husband and an adult daughter with mental disabilities. About the fact that my mother and my sister are aging. About the increasingly obvious fact that in addition to being a mother of young kids, one with severe food allergies, I am also a long-distance caregiver.

I have never understood how this is going to work. To be honest, I have preferred straight-up denial, because my life feels way too complicated already. But I am starting to do what I do best when faced with complex, uncertain, and slightly terrifying challenges: write. I have started to read about eldercare issues and to process what I am reading, one sentence at a time. I have a lot to learn.

Caring for aging parents is a hot topic right now. Just take a look at the June 11 Time magazine issue, with its cover article “How to Die” by Joe Klein. Or last month’s New York magazine, with the devastating cover article by Michael Wolff: “Mom, I Love You. I Also Wish You Were Dead. And I Expect You Do, Too.” (That one nearly sent me over the edge. Wolff is one of the most brutally honest journalists I’ve ever read.) Sandra Tsing Loh recounts her own familial story in an Atlantic magazine review of three recent books about caring for aging parents, one of which I’m reading: Jane Gross’s A Bittersweet Season: Caring for Our Aging Parents—and Ourselves. So far, it’s quite good; as a journalist, she’s a bit more measured in a genre that tends toward trafficking in “Elderschadenfreude” (pure Sandra Tsing Loh, and she hits the nail on the head). But even Gross’s story provides little to no comfort.

Gross writes with an attuned sensitivity to gender. For example, she observes that most adult children caring for elderly parents are daughters. While many are sons, the numbers aren’t equal. Just like there’s a “mommy track,” there’s a “daughter track.

But these two worlds share less than we might think, she argues. For example, she writes that while many companies have addressed (some of) the needs of working parents with programs like parental leave policies, few if any workplaces have addressed the needs of caregiving adult children with comparable policies and programs.

This depresses me. As if we’ve made enough progress on support for working families. (Have I mentioned that my own maternity leave was unpaid?) To add insult to injury, according to Gross, we’re even further behind with policies supporting nonprofessional caregivers.

The childcare paradigm doesn’t work well for the end of life. Gross points out that pregnancy and birth can generally be planned for, well in advance. (Adoption, of course, is another story.) But most end-of-life crises can’t.

Thankfully my dad fell during summer vacation. But what about when something happens during the semester? Or during a family trip? I’ve realized that I have to accept a fair amount of constant uncertainty.

Gross writes to help adult children navigate these uncertainties (she is also the founder of The New Old Age Blog at The New York Times). So far, I’m finding A Bittersweet Season helpful. I even thought about giving it to my mother, but I hesitated. The book isn’t really written for her. So I have started to look for resources for caregiving wives—another “track,” I realize, similar and yet different from the “mother” and “daughter” tracks.

All three “tracks” occur when women (still) perform caregiving work and shoulder the invisible emotional toll of caregiving—despite the way that traditional gender roles have opened up. As Peggy Orenstein writes in Flux, our world remains “half-changed”: institutions and social policies have not kept pace with how many families now live their lives. And, I would add, roles such as daughterhood and wifehood—like motherhood—carry with them gendered stereotypes and expectations. The dutiful daughter. The martyred wife. These can be damaging, particularly when others expect women to do it all, and to bear their burden silently.

In 1976, Adrienne Rich split apart the institution of motherhood from the act of mothering. The first she viewed as oppressive, the second as empowering. Other feminists and gender activists have worked to preserve mothering (or, simply, parenting) while questioning its alignment with sex and gender identity. Is it possible to do something similar with caregiving for the elderly? Do we need a movement to help enable all of us to care for our families, both those we are born with and those we choose?

In this town of writerly goodness, every once in a while an event rolls around that I feel I just can’t miss.  Still trying to line up a sitter, but damned if I won’t be there.  If anywhere near NYC this Monday night, I strongly encourage you to hightail it to this panel too — which features members of my awesome authors’ group, and the founder of The OpEd Project, the organization I work with. Here’s the schpiel:

Navigating the Pink Ghetto

Topics around gender politics, family issues and women’s health are crucial mainstays of journalism, so why do issues pertaining to women get sidelined? And how can so-called “women’s topics” get an intellectually sound, politically savvy hearing in a media world that often wants a soft focus on hard issues? Hear from tough women journalists spilling red ink on pink topics, and how they manage the gender divide in serious ideas-based reporting.

FEATURING

EMILY BAZELON

Senior editor, Slate
Contributing writer, The New York Times Magazine
Author of a forthcoming book about bullying, Sticks and Stones, to be published early next spring
ANNIE MURPHY PAUL

Author, Origins and Brilliant
Contributing writer, TIME magazine
Contributor, NPR’s MindShift.com

PAMELA PAUL

Author, The Starter Marriage and The Future of Matrimony, Pornified, and Parenting, Inc.
Features editor and children’s book editor, The New York Times Book Review

KATIE ORENSTEIN

Founder and CEO, The OpEd Project

Author, Little Red Riding Hood Uncloaked

GUARANTEE YOUR PLACE, RSVP NOW

There’s this recent study that shows that in countries with higher divorce risk, married women work more hours than in countries with lower divorce risk. The same study looks at how married men work more when the tax rate is lower, and work less when the tax rate is higher. The study, using data from the US and Europe, was done by a trio of economists, and can be read here, and it is cited in Freakonomics here.

The authors were curious about why people in the US work more than those in Europe. They start with this: on average, people in the US work more than people in Europe—one study shows the difference is 30 percent more; other studies show how little vacation time, paid sick leave, or family leave that the US has relative to European countries—although the current recession may end up reducing these differences.

Sure enough, divorce rates plus tax rates told the story. Even cooler, the explanation was much clearer when they divided their data up into menfolk and womenfolk. Men’s labor varied with tax rates, though women’s did not. When tax rates were relatively low, as in the United States, men worked more hours, when tax rates were relatively high, as in Belgium, men worked fewer hours. No such variation existed for women. Meanwhile women’s labor varied with divorce rates, but not men’s. So high divorce rates, more women’s work hours–as in the USA. Low divorce rates, fewer women’s work hours–as in Ireland. No such pattern existed for men; divorce rates didn’t matter.

The authors interpret their results like this:

We believe [women’s work pattern] is because marriage provides an implicit social insurance since the spouses are able to share their income. However, if divorce rates are higher in a society, women have a higher incentive to obtain work experience in case they find themselves alone in the future. The reason the incentive is higher is because in our data, women happen to be the second earner in the household more often than men. European women anticipate not getting divorced as often and hence find less reason to insure themselves by working as much as American women.

And the study was covered with enthusiasm in Freakonomics, “Why do American Women Work More…?” A tour of coverage in the blogosphere highlighted the “woman’s predicament” foregrounded by this interesting study, here and here, for example. (A counter example that included a look at both sides of the equation is here.)

I liked the study. Still, the way the study gets talked about you’d think it was only about women’s behavior, not about men’s behavior, too, or about what it means for humans. Men did not respond to divorce rates but did respond to tax rates. Yet there was no curiosity about that. Men were being taken for granted. And so was the logic of labor markets, marriage, and patriarchy. And so was the economic model that treats as “normal” (and normative) that people will maximize income unless policy has messed things up.

You hardly even notice that it is happening, but this is the kind of thing that happens all the time. In this story, men’s behavior gets treated as if it is “natural.” The baseline is that men are expected to respond to tax rates, and are normal because they do so. And now we have to figure out those puzzling women. They are kind of like men in that they go to work, but they don’t work the same as men. What’s up with that? When it comes to labor market behavior, men are treated as the “normal” or “control” category and women as the “experimental” category.

So who cares? I’ll tell you: if you give yourself time to interpret men’s as well as women’s behavior in this study you start to understand what men and women have in common. Perhaps from this view it will emerge for you as has for me that this study looks like it is about “safety nets.” The role of the government in many European countries has been to provide basic security for all citizens. That’s where higher taxes over there go–universal health care, child-care, more generous retirement and unemployment benefits, and other social services and income supports. Lower taxes mean fewer public services and not much of a safety net.

So in this study I see marriage as another kind of safety net–as do most of those who interpreted the study. The safety net interpretation is one with deep roots. The breadwinner/homemaker model was the 19th century version of “social safety net” complete with a “family wage” for the breadwinner man to support a homemaker woman to take care of home production as well as to be a live-in psychologist to the breadwinner, a gentle voice who would soften the angry blows of the harsh world outside the home. (That’s how they talked about it then.) And even though not all families had a family wage, the model was idealized and seared into social and economic policy, especially in the United States. In fact so much so that it continues to play a role today, as the US marriage movement highlights.

Though the traditional imagery hangs around, the reality hasn’t existed for nearly 40 years. We don’t have a family wage anymore; instead, families keep their heads above water in the US by having two earners.

So, watch out for your implicit comparison group. Watch out for what gets cast as normal. Ideas about normal can get in the way of seeing possibility, and seeing things as they really are, or at least seeing things from more than one point of view.

The study wasn’t talked about in terms of the unifying theme of safety netting. It talked about a story of how “women are different.” Look, women aren’t like men, they don’t respond to taxes the way men do. And the way the men’s side of the story is told—well it isn’t really told but implied—is that men constitute the “comparison group” the natural worker, who responds to the labor market in the way that “we expect.” What I expect, as I think about this study, is that men and women will feel more ease when there is more of a safety net for all.

-Virginia Rutter

We’ve teamed up!  Deborah Siegel (a.k.a. Mama w/ Pen and our very own Girl w/ Pen founder) and I have collaborated on an OpEd on Elisabeth Badinter’s new book, The Conflict: How Modern Motherhood Undermines the Status of Women.  We agree with some of her arguments, but take issue with others.  Our call?  Let’s move past all the mommy wars and focus on the real needs of U.S. mothers.  Read more over at CNN.com.

On a personal note, I cannot think of anything I have done this past year that has been as gratifying as working with Deborah on this piece.  Two is definitely better than one!

Talk about irony: the same week that Rock Center with Brian Williams aired a story about a growing “concussion crisis” in girls’ soccer, I also got the curriculum for my 11-year-old daughter Maya’s soccer practice: “Heading (attacking and defensive situations, being brave).”

I definitely watched the Rock Center story with concern. Research shows that girls report twice as many concussions as boys in sports they both play.

The report aired Wednesday, and Maya practiced heading on Thursday. On Sunday we sat on the sidelines watching Maya’s team face off against a northern New Jersey opponent. The girls fought to control the ball, with neither team clearly dominating.

Then, as if in slow motion, I watched the ball sail through the air toward Maya at midfield. She stepped into the ball, leaned forward, and headed it toward the goal. Of course, she was fine. I’m sure she felt pleased with herself for putting the new technique into play in a game situation. To be honest, I was pleased myself, although anxious at the same time.

And here are the questions I’ve been turning over since the game: is this “crisis” one that should change the game of youth soccer for girls? Should heading be banned? One expert in the Rock Center story, Bob Cantu, the director of sports medicine at Emerson Hospital in Concord, MA suggests that it should, because “girls as a group have far weaker necks.”

Naturally I take concussions seriously and would not want to do anything that could jeopardize Maya’s health. But I’m not sure I buy this so-called crisis.  For one thing, the research draws on data from high school athletes.  How much can we generalize from that population to the nearly 1.5 million girls who play youth soccer in the US every year?

What’s more, is this thinking about girls’ weakness that much different from earlier arguments suggesting women shouldn’t be educated because our brains are smaller than men’s? Or that women shouldn’t walk alone at night because we face the threat of rape?

It seems to me that ideas about “protection” are often a guise for social constraints on women and girls.  What athletic opportunities would we curtail in the name of “safety” for girls?

For now, at least, I want Maya to practice “being brave,” and if that means heading the ball, I’ll be cheering her on.

But GWP readers, what do you think? How do you think about “risk” and “safety” for your daughters or sons?

I’ve written before about the gendering phenomenon—how eager we are to gender our children, for whom gender, not to mention sex and sexuality, are meaningless, carrying only the meaning that we as skewed, culturally shaped adults bring with us.

My daughter Maybelle, although she has a very gendered first name, does not go through the world as a specifically gendered being.  She is equally fascinated with baby dolls and dinosaurs.  She loves trains and Willie Nelson’s “Whiskey River” (appropriate for a three year old?  Perhaps not, but she does love it).  There are many factors that lead to this androgyny of interests:  her parents, of course, being fairly radical feminists plays a role.  But also I think she doesn’t pick up the gendered cues that her classmates are beginning to perform and observe.  Having an intellectual disability is sort of beneficial in that it screens the subtle nuances—nuances that I consider fairly pathological.

Emotions, Maybelle responds to.  But the notion that “girls wear dresses, boys play with dinosaurs”?  Not so much.

Adults, however, love some gender distinctions, particularly when little kids are concerned.  Many adults who adore Maybelle get tingly at the idea of dressing her in little girl dresses.  And here’s the most successful strategy to come along:  Maybelle’s preschool teachers have suggested that they’ll have an easier time helping to potty train her if we send her to school in dresses.

That’s been an effective strategy.  We’re very eager for Maybelle to become potty trained, and she seems eager to give it a try, herself.  So we’re sending her to school in dresses.

Her dress-wearing was big news.  Every person in Maybelle’s preschool—from the director to the undergraduate student workers—have commented on the fact that Maybelle often comes to school these days wearing dresses.  My mom, who lives about 500 miles away from us, heard about this fact through a friend of a friend, who found this significant enough that she called my mom up to say, “I hear Maybelle’s wearing dresses!”

A couple of things strike me about this.  First of all, if dresses really do make potty training easier, why aren’t the little boys in Maybelle’s class being encouraged to come to school in dresses?  And second,  it’s interesting how much validation Maybelle gets.  “You look so pretty!” adults say to her.

There’s something satisfying to many adults about a girl wearing a dress, and they’re initiating the process that will make this feel satisfying to Maybelle, too.  She’ll pick up on the fact that she gets excessive good vibes when she wears a dress.  They don’t encourage boys to come to school in dresses for the same reason that they validate Maybelle for wearing one:  these are both phenomena related to us creating and perpetuating gender.

Of course she’s adorable in her dresses, but she’s also adorable when she looks a bit like a rock chick, like a comic book fan, like a nerd in her glasses, reading a book.  I want her to have a lot of space to develop the personal expression that fits her best, no matter how that maps onto our current configurations of gender.

THIS SUNDAY, MAY 13, 2012 — Mother’s Day in the United States — women everywhere will simultaneously post this letter to their blogs, websites and Facebook pages, to honor the work of Mothers around the world.

YOU ARE INVITED TO ADD YOUR VOICE. To join our Mother’s Day Blog-In simply,

1. Copy & paste this letter on your blog, Facebook or Google+ page.

2. Add your name and links to your site, work or organization in the comments at https://www.facebook.com/MothersSpeakOut

3. Tweet, share and post the link to your letter using the hashtag #MothersSpeakOut

We also invite all mothers to post a comment or image about their authentic, true reality as a mother — ones that they don’t often see reflected in the mainstream media.

* * * * * * *

Together, Mothers Are Powerful.

Last month’s furor over the remarks of political pundits and candidate’s wives launched a flurry of conversation among mothers.

Mothers have a voice of their own to add to the discussion. Authors, activists and others have been writing and identifying the issues raised this political season for decades, and women have been listening, again and again.

It’s time for mothers’ own voices to be heard.

We are a bi-partisan coalition of women’s organizations, experts, and writers who have diligently worked on bringing mother’s issues into the mainstream political discussion.

Some of us are advocates, and some are community organizations. Many of us are authors and experts about mothers’ lives as well.  All of us recognize the value of a mother’s contribution to her family, both the paid and unpaid work that women do.

Our message is simple: all mothers need more support.

This Mother’s Day we want to get the word out about our ideas, our work, and our priorities. We offer the following list to provide resources for real information and places for women to gather for intelligent discourse on the many problems — and solutions — to the issues facing mothers and families.

We offer this list as an alternative to the tired and cliched coverage of mothers in the mainstream media.

Please join your voice with ours this Mother’s Day. Together, Mothers are powerful.

* * * * *

ANN CRITTENDEN

Author, The Price of Motherhood

Co-founder “MOTHER: Mothers Ought to Have Equal Rights”

DEBRA LEVY

Past President, Mothers & More

Greetings – we are Annie Howell and Lisa Robinson, guest bloggers for Mama w/Pen. We’re here because our film, SMALL, BEAUTIFULLY MOVING PARTS opens Friday, May 11 in New York City, then moves on to over ten cities nationwide. It’s a story about technology and self-expression, love and major life changes. Here’s the synopsis:

When technophile Sarah Sparks (Anna Margaret Hollyman) becomes pregnant, her uncertainties about motherhood trigger an impulsive road trip to the source of her anxiety: her long-estranged mother living far away and off-the-grid.

So, yes, our movie features a female tech-head protagonist, and that choice often has us thinking about gender and technology. The New Yorker this week features an article on youth hacker George Hotz, who at 17 was the first person to decode an iphone in order to use his existing data plan. George describes hacking as such to New Yorker writer David Kushner:

“It’s a testosterone thing,” he told me. “It’s competitiveness, but it isn’t necessarily competitiveness with other people. It’s you versus the system. And I don’t mean the system like the government thing, I mean the system like the computer. ‘I’m going to stick it to the computer. I’m going to make it do this!’ And the computer throws up an error like ‘No, I’m not going to do this.’ It’s really a male thing to say, ‘I’m going to make you do this!’ ” (“George Hotz, Sony, and the Anonymous Hacker Wars” by David Kushner, May 7, 2012.)

Is “I’m going to make you do this!” really, um, exclusively male? Granted this is one statement by one individual, but it’s reflective of an idea that’s clearly permeating our culture: that technology is more or less for the boys.

And on to film directing ….

In 2004 The New York Times ran an article by Nancy Hass that praised the number of women working in Hollywood as producers but included a sidebar about women directors that expressed some surprising assumptions. (“Hollywood’s New Old Girls’ Network” by Nancy Hass, April 24, 2005.)

The Dean of USC Film School, Elizabeth Daley, said this to Nancy Hass:

“There are talented girls who want to do this, but so far they haven’t done what the boys do – band together and sacrifice everything to make a small film,” she said. “It’s those films that eventually find their way into the hands of studio executives looking for the next hot young thing.”

And there’s more:

“Young women are less likely to get support, both financial and emotional, from their parents,” Ms. Daley added. “In my experience, parents of girls aren’t as eager to give them their life savings to make a movie,” she said.

A former studio head, who did not give her name in order to protect relationships, said: “The fact is that to be a director you have to be unbelievably ruthless…. They have a cold streak that most women I know don’t have and don’t want to have. They are both artist and commander, and they have a maniacal vision that precludes them from caring about anything but the film.”

Apologies, but denying all women the right to a natural-born cold streak, a maniacal spirit and the right to be, well, bossy – “I’M GOING TO MAKE YOU DO THIS!” — is only relevant if we allow these ridiculous stereotypes to continue to circulate.

Hack female style! And direct movies. We went to a film school wherein half of the class was female – and those women brought to their craft everything unique about themselves, and certainly got their movies made. Filmmaking is as varied in methodology as are the stories that any one individual wants to tell. Our story is about a woman and her love of machines … and how she comes undone in a transition toward parenthood. Watch the trailer here – and hope to see you opening weekend at Cinema Village!

—Annie Howell and Lisa Robinson, co-directors

SMALL, BEAUTIFULLY MOVING PARTS

As a sexual health researcher, I have followed the saga of HPV (human papillomavirus) vaccination since the early 2000s. I’m posting this month’s column early to address three news stories that recently caught my attention – both for what they reported and also for what they left out:

March 26, 2012: PRNewswire report on Harold zur Hausen’s remarks at the annual meeting of the Society of Gynecologic Oncology. Having won the 2008 Nobel Prize in Medicine for discovering the link between HPV and cervical cancer, zur Hausen kept the spotlight on cervical cancer when he advocated for HPV vaccination of young females and males in order to “eradicate cervical cancer.” While I advocated for non-sexist HPV vaccination policies back in a 2010 Ms. Magazine article, I was surprised by reports that zur Hausen favored male vaccination: “…if society were to vaccinate just one gender to prevent the spread of cervical-cancer causing HPV, it would be more effective to vaccinate just males.”  I found myself asking two questions: (1) Why base medical recommendations on heterosexist assumptions that girls/women only contract cancer-causing strains of HPV from male partners? (2) Why continue to narrowly focus on HPV as a cause of cervical cancer, when a growing body of research documents its role in a range of genital cancers as well as often fatal oral-throat cancers?

April 2, 2012: The New York Times offers a summary of a study published in the March issue of the British Medical Journal: the findings suggest that HPV vaccination “can significantly cut the likelihood of virus-related disease even among women who have had surgery for cervical cancer caused by HPV.” The strongest prevention effect – 64% reduction in risk – was for women who had the most serious kinds of cervical cancer. The article quotes Dr. Elmar A. Joura, associate professor of gynecology at the Medical University of Vienna: “Regardless of your age or your history, a vaccination can prevent new disease.” Key question not addressed by this article: why does the CDC have an upper-age limit of 26 years old for HPV vaccination? Last year, Canada raised their upper-age limit to 45 – how much longer will ‘older’ Americans have to wait?

April 4, 2012: Forbes article on “The Gardasil Problem” fails to address the full scope of HPV vaccination ‘problems.’ First, the author misleads readers into thinking that HPV-related oral-throat cancers are “a new form” – again, see not only the 2010 Ms. Magazine article but also the Oral Cancer Foundation’s thorough summary of the decades of research linking sexually-transmitted HPV to serious oral cancers.

The author also misstates the focus/bias of Merck’s original years of marketing Gardasil: “When it was introduced in 2006…Merck began an advertising push to raise awareness of the risks of HPV.” What ads did he see? I and other consumers of mainstream media were exposed to a series of commercials that referred to Gardasil as “the cervical cancer vaccine” and strategically obscured message about “HPV-related diseases”, never clarifying for viewers that HPV was, in fact, sexually transmitted.  While I offered a feminist critique of the branding and marketing of Gardasil in my 2008 book and several blog posts – trying to get the public to understand that “You don’t need to have a cervix to benefit from the cervical cancer vaccine” – Merck did not change to a focus on Gardasil as a STD vaccine until it received FDA approval for male vaccination…until profits depended upon bursting the bubble of the mythical cervical cancer vaccine.

Next, the author not only makes a heterosexist assumption but also unnecessarily demonizes oral sex on women as the ‘usual’ mode of transmission: “Usually transmitted when men perform oral sex on women, it can also spread through other forms of contact, perhaps even just kissing.”  If kissing can transmit the virus, the why is he so sure that most of men with HPV-related oral-throat cancers skipped ‘first base’ and went straight to ‘third base’? If, and this is a big ‘if’, clinical studies can verify unprotected oral sex as the primary mode of transmission, then why not offer readers a brief education on the vaccine-free ways to practice safer oral sex? 

Finally, the author unnecessarily dashes readers’ hopes for the near future: “tests that might well prove that [Gardasil] can prevent the new throat cancer strain would take at least 20 years, until the boys sampled actually became sexually active and then contracted the disease.” Why would these tests take 20 years? Does this author think that a boy who is vaccinated at age 12 will not perform oral sex until he’s 20+ years old? Where is the data to show it would take another ten years for HPV-related oral and throat cancers to develop?  In addition, the author fails to point readers towards the likely source of delay: a lack of interest by the makers of the two FDA-approved HPV vaccines.   

A 2010 article in the Journal of the National Cancer Institute not only clarifies the challenges of developing effective screening for oral HPV infections but also reports the truth about Merck’s failure to move forward with testing HPV vaccination as prevention of oral and throat cancers. Maura Gillison, M.D., Ph.D., a leading researcher on HPV-related head and neck cancers at Ohio State University in Columbus, explained why clinical trial plans were derailed in 2010: “We were 6 weeks from enrolling the first patient when I got an e-mail saying it was no longer in the interest of Merck to conduct the trial.” The article also quotes Pam Eisele, a Merck spokeswoman:

“The link between HPV infection and head and neck cancers continues to be an area of scientific interest for Merck; however, we currently do not have any plans to study the potential of Gardasil to prevent HPV-related oropharyngeal cancers. In 2008, we did conduct a small pilot study to assess our ability to obtain adequate and valid oropharyngeal samples. While the results of the pilot study were promising, due to competing research and business priorities we ultimately decided not to move ahead with an efficacy study at this time.”

Why is Forbes not asking for a more complete explanation of those “competing research and business priorities”?  We, the American public, should demand more funding find out how to prevent cancers which research shows to be on the rise and more fatal than cervical cancer in the U.S.

The one section of this Forbes article that some readers might find valuable is its summary of the data on the safety record of HPV vaccination.  However, as I’ve said before, I am not advocating that vaccination is the only way to reduce one’s risk of contracting cancer-causing strains of HPV.  Those who decide not to vaccinate themselves and/or their children need to learn the facts about HPV prevention, testing, diagnosis, and treatment: check out the American Social Health Association’s online HPV and Cervical Cancer Prevention Resource Center.