health/medicine

This week Michael Douglas’ announced that his oral cancer was caused by a virus (human papillomavirus) likely transmitted through oral sex.  Media coverage, however, has been conflating the virus and the sexual activity with headlines like this:

ABC News:

FOX News:

San Francisco Chronicle:

The day after the story broke, Douglas’ representatives clarified that his cancer wasn’t caused by cunnilingus, but by the virus itself.

This is an interesting example of the way that a practice can be falsely conflated with a disease.  It brings back the fantastical stories of the 1800s that masturbation was the cause of  liver, kidney, and lung disease; arthritis; headache, memory loss, epilepsy, and neurological problems; back pain; impotence; cancer; and death.

Like masturbation was (and maybe still is), cunnilingus is taboo enough that it can be made into the villain in a story about cancer.  Imagine, as a counterfactual, a headline that said that syphilis was caused by sexual intercourse.  This is clearly wrong.  We all know that syphilis is transmitted by unprotected sexual intercourse.  As Douglas’ confession reveals, and the data demands, it’s about time we were as comfortable talking about the risks and rewards of cunnilingus.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

Cross-posted at Inequality by (Interior) Design.

The problem:

A Brazilian modeling agency, Star Models, recently released a new series of anti-anorexia PSA advertisements. They illustrate one of the ways ultra-thin body ideals characterizing women’s bodies in the fashion industry today are institutionalized, or made part of the way we “do” fashion. Fashion sketches — the way that people communicate designs to one another — idealize these bodies, with their exaggerated proportions, long slender limbs, and expressionless faces. The PSAs place real women alongside the sketches, graphically altered to similar proportions, in order to problematize the ideal.

Sociology professors are constantly asking students to analyze what they might be taking for granted. One issue we take for granted is that the images on the left are what “fashion” looks like and ought to look like. That they are culturally recognizable as fashion sketches speaks to the ways in which hyper-thin feminine bodies are institutionalized at a fundamental level in the fashion industry today.

The Dove Evolution video — as a part of their “Campaign for Real Beauty” — vividly illustrates the work that goes into the production of advertisements. Using a time-lapse video depicting the diverse labor that goes into the production of an ad was a simple illustration of the impossibility of contemporary beauty ideals. Viewers are left thinking, “Of course we can’t look like that. She doesn’t even look like that.”

Star Models’ anti-anorexia ads promote a similar message, but also call our attention to the more dangerous aspects of adherence to industry ideals. Similar to depictions of what Barbie might look like as a real woman, altered images of dangerously thin models aside these sketches have a very different feel from the sketches they imitate.

What is being done about it?

In 2007, the Council of Fashion Designers of America (CFDA) passed a Health Initiative in recognition of an increasingly global concern with the unhealthily thin bodies of models and whether/how to promote change in the industry. The CFDA is working to better educate those inside the industry to identify individuals at risk, to require models with eating disorders to seek help and acquire professional approval to continue working, to develop workshops promoting dialog on these issues, and more.

The CFDA’s Health Initiative, however, treats eating disorders as an individual rather than social problem. This allows the CFDA to obscure the role it might play in perpetuating cultural desires for the very bodies it purports to “help” with the Health Initiative.

Susan Bordo famously wrote about anorexia as what she termed “the crystallization of culture.” We like to draw firm boundaries between normality and pathology. But Bordo suggests that anorexia is more profitably analyzed as culturally normative than as abnormal. Similarly, Star Models’ PSAs play a role in framing the fashion industry as (at least partially) responsible for ultra-thin feminine body ideals. Yet, they arguably fall short of providing institutional-level solutions as the tagline — ”You are not a sketch. Say no to anorexia.” — concentrates on individuals.

The CFDA’s focus on health initiatives and support for individuals suffering from anorexia, bulimia and other eating disorders are critical aspects of recognizing issues that seem to plague the fashion industry. While this surely helps some individual women, the initiatives simultaneously avoid the cultural pressures (in which the fashion industry arguably plays a critical role) that work to systematically conflate feminine beauty with ultra-thin ideals. Similar to problems associated with focusing attention only on the survivors of sexual assaults (failing to recognize the ways that sexual violence is both institutionalized and embedded in our culture), these images simply illustrate that individual-level solutions are unlikely to produce change precisely because they fail to locate “the problem” and ignore the diverse social institutions and ideals that assist in its reproduction.

Thanks to a student in my Sociology of Gender course, Sandra Little, for bringing this campaign to my attention.

Tristan Bridges is a sociologist of gender and sexuality at the College at Brockport (SUNY).  Dr. Bridges blogs about some of this research and more at Inequality by (Interior) Design.  You can follow him on twitter @tristanbphd.

Cross-posted at Montclair SocioBlog.

Does “the abortion culture” cause infanticide?  That is, does legalizing the aborting of a fetus in the womb create a cultural, moral climate where people feel free to kill newborn babies?

It’s not a new argument.  I recall a 1998 Peggy Noonan op-ed in the Times, “Abortion’s Children,” arguing that kids who grew up in the abortion culture are “confused and morally dulled.”*  Earlier this week, USA Today ran an op-ed by Mark Rienzi repeating this argument in connection with the Gosnell murder conviction.

Rienzi argues that the problem is not one depraved doctor.  As the subhead says:

The killers are not who you think. They’re moms.

Worse, he warns, infanticide has skyrocketed.

While murder rates for almost every group in society have plummeted in recent decades, there’s one group where murder rates have doubled, according to CDC and National Center for Health Statistics data — babies less than a year old.

Really? The FBI’s Uniform Crime Reports has a different picture.

Many of these victims were not newborns, and Rienzi is talking about day-of-birth homicides — the type killing Dr. Gosnell was convicted of, a substitute for abortion.  Most of these, as Rienzi says are committed not by doctors but by mothers.  I make the assumption that the method in most of these cases is smothering.  These deaths show an even steeper decline since 1998.

Where did Rienzi get his data that rates had doubled?  By going back to 1950.

The data on infanticide fit with his idea that legalizing abortion increased rates of infanticide.  The rate rises after Roe v. Wade (1973) and continues upward till 2000.

But that hardly settles the issue. Yes, as Rienzi says, “The law can be a potent moral teacher.”  But many other factors could have been affecting the increase in infanticide, factors much closer to actual event — the mother’s age, education, economic and family circumstances, blood lead levels, etc.

If Roe changed the culture, then that change should be reflected not just in the very small number of infanticides but in attitudes in the general population.  Unfortunately, the GSS did not ask about abortion till 1977, but since that year, attitudes on abortion have changed very little.   Nor does this measure of “abortion culture” have any relation to rates of infanticide.

Moreover, if there is a relation between infanticide and general attitudes about abortion, then we would expect to see higher rates of infanticide in areas where attitudes on abortion are more tolerant.

The South and Midwest are most strongly anti-abortion, the West Coast and Northeast the most liberal.  So, do these cultural difference affect rates of infanticide?

Well, yes, but it turns out the actual rates of infanticide are precisely the opposite of what the cultural explanation would predict.  The data instead support a different explanation of infanticide: Some state laws make it harder for a woman to terminate an unwanted pregnancy.  Under those conditions, more women will resort to infanticide.  By contrast, where abortion is safe, legal, and available, women will terminate unwanted pregnancies well before parturition.

The absolutist pro-lifers will dismiss the data by insisting that there is really no difference between abortion and infanticide and that infanticide is just a very late-term abortion. As Rienzi puts it:

As a society, we could agree that there really is little difference between killing a being inside and outside the womb.

In fact, very few Americans agree with this proposition. Instead, they do distinguish between a cluster of a few fertilized cells and a newborn baby. I know of no polls that ask about infanticide, but I would guess that a large majority would say that it is wrong under all circumstances.  But only perhaps 20% of the population thinks that abortion is wrong under all circumstances.

Whether the acceptance of abortion in a society makes people “confused and morally dulled” depends on how you define and measure those concepts.  But the data do strongly suggest that whatever “the abortion culture” might be, it lowers the rate of infanticide rather than increasing it.

* I had trouble finding Noonan’s op-ed at the Times Website.  Fortunately, then-Rep. Talent (R-MO) entered it into the Congressional Record.

Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.

Hint from Dmitriy T.C.: he probably wears shorts to work.

Here’s the infographic, sent in also by sociologist Michael Kimmel, revealing the highest paid employee in each state.  Yellow, orange, and green states are all ones in which the most money goes to an athletic coach.  More details at DeadSpin.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

While some austerity advocates really fear (although incorrectly) the consequences of deficit spending, the strongest proponents are actually only concerned with slashing government programs or the use of public employees to provide them.  In other words their aim is to weaken public programs and/or convert them into opportunities for private profit. One measure of their success has been the steady decline in public employment.  Floyd Norris, writing in the New York Times notes:

For jobs, the past four years have been a wash.

The December jobs figures out today indicate that there were 725,000 more jobs in the private sector than at the end of 2008 — and 697,000 fewer government jobs. That works into a private-sector gain of 0.6 percent, and a government sector decline of 3.1 percent.

In total, the number of people with jobs is up by 28,000, or 0.02 percent.

How does that compare? It is by far the largest four-year decline in government employment since the 1944-48 term. That decline was caused by the end of World War II; this one was caused largely by budget limitations.

The chart below, taken from the same post, also reveals just how weak private sector job creation has been over the past 12 years (compare the top three rows — the presidencies of Obama and Bush — w This graphic from the New York Times highlights just how significant the decline in public employment has been in this business cycle compared with past ones.  Each line shows the percentage change in public sector employment for specified months after the start of a recession.  Our recent recession began December 2007 and ended June 2009.   As you can see, what is happening now is far from usual.

It is also worth noting that despite claims that most Americans want to see cuts in major federal government programs, the survey data show the opposite.  For example, see the following graphic from Catherine Rampell’s blog post. As Rampell explains:

In every category except for “aid to world’s needy,” more than half of the respondents wanted either to keep spending levels the same or to increase them. In the “aid to world’s needy” category, less than half wanted to cut spending.

Not surprisingly, this assault on government spending and employment will have real consequences for the economy and job creation. All of this takes us back to the starting point — we are talking policy here.  Whose interests are served by these trends?

Martin Hart-Landsberg is a professor of economics at Lewis and Clark College. You can follow him at Reports from the Economic Front.

Cross-posted at Montclair SocioBlog.

The Washington Post has provided some data on medical costs across a selection of countries (Argentina, Canada, Chile, and India in grey; France, Germany, Switzerland, and Spain in blue; and the U.S. in red). The data reveal that American health care is very expensive compared to other countries.

No wonder the US spends twice as much as France on health care.  In 2009, the U.S. average was $8000 per person; in France, $4000.  (Canada came in at $4800).  Why do we spend so much?  Ezra Klein quotes the title of a 2003 paper by four health-care economists:  “it’s the prices, stupid.”

And why are US prices higher?  Prices in the other OECD countries are lower partly because of what U.S. conservatives would call socialism – the active participation of the government.  In the U.K. and Canada, the government sets prices.  In other countries, the government uses its Wal-Mart-like power as a huge buyer to negotiate lower prices from providers.  (If it’s a good thing for Wal-Mart to bring lower prices for people who need to buy clothes, why is it a bad thing for the government to bring lower prices to people who need to buy, say, an appendectomy? I could never figure that out.)

There may also be cultural differences between the U.S. and other wealthy countries, differences about whether greed, for lack of a better word, is good.  How much greed is good, and in what realms is it good?  Klein quotes a man who served in the Thatcher government:

Health is a business in the United States in quite a different way than it is elsewhere.  It’s very much something people make money out of. There isn’t too much embarrassment about that compared to Europe and elsewhere.

So we Americans roll along, paying several times what others pay for medical procedures, doctor visits, and drugs.

Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.

Dylan Matthews, blogging in the Washington Post, discusses a very interesting paper that provides evidence showing that politicians seriously underestimate the progressivity of their constituents.

David Broockman and Christopher Skovron, the authors of the paper, “surveyed every candidate for state legislative office in the United States in 2012 [shortly before the November election] and probed candidates’ own positions and their perceptions of their constituents’ positions on universal health care, same-sex marriage, and federal welfare programs, three of the most publicly salient issues in both national-level and state-level American politics during the past several years.”  They then matched the results with estimates of the actual district- and issue-specific opinions of those residing in the candidates’ districts using a data set of almost 100,000 Americans.

Here is what they found:

Politicians consistently and substantially overestimate support for conservative positions among their constituents on these issues. The differences we discover in this regard are exceptionally large among conservative politicians: across both issues we examine, conservative politicians appear to overestimate support for conservative policy views among their constituents by over 20 percentage points on average… Comparable figures for liberal politicians also show a slight conservative bias: in fact, about 70% of liberal office holders typically underestimate support for liberal positions on these issues among their constituents.

The following two charts illustrate this bias when it comes to universal health care and same sex marriage.

As Matthews explain:

The X axis is the district’s actual views, and the Y axis their legislators’ estimates of their views. The thin black line is perfect accuracy, the response you’d get from a legislator totally in tune with his constituents. Lines above it would signify the politicians think the district more liberal than it actually is; if they’re below it, that means the legislators are overestimating their constituents’ conservatism. Liberal legislators consistently overestimate opposition to same-sex marriage and universal health care, but only mildly. Conservative politicians are not even in the right ballpark.

The authors found a similar bias regarding support for welfare programs.  Perhaps even more unsettling, the authors found no correlation between the amount of time candidates spent meeting and talking to people in their districts while campaigning for office and the accuracy of their perceptions of the political positions of those living in their districts.

One consequence of this disconnect is that office holders, even those with progressive views, are reluctant to take progressive positions.  More generally, these results speak to a real breakdown in “the ability of constituencies to control the laws that their representatives make on their behalf.”

Martin Hart-Landsberg is a professor of economics at Lewis and Clark College. You can follow him at Reports from the Economic Front.

The representation of sexuality and safer sex in public health campaigns is fascinating given our simultaneous cultural obsession with yet pathologization of sexual behavior.  Safer sex campaigns and materials not only seek to increase prevention behaviors but also produce a range of social meanings surrounding gender, bodies, and desire.  Most are produced by organizations that fall well within the mainstream; others are not.  This post is about one of the latter (warning: sexual explicitness).

The following resource, titled “Top 5 Reasons to Fuck a Transguy” was produced and distributed by a collaborative project of the San Francisco-based Asian and Pacific Islander Wellness Center.  tm4m is a group for transgender men whose goal is to “provide information, education and support to transmen who have sex with men (both other transguys and cisguys).”

This material is interesting for two main reasons.  First, it combines traditional health education with an erotic, sex-positive context that is missing from most public health campaigns.  For the most part, public health approaches to HIV prevention and sexual health promotion utilize a “sex-negative” approach to sexual behavior; in other words, sex is represented as potentially dangerous or problematic and focus narrowly focused on its negative aspects, such as disease transmission.  Even more progressive “comprehensive” approaches to sexual health education (that is, approaches that do not focus solely on abstinence) tend to center on the potentially dangerous outcomes of sex and how to prevent them while ignoring the pleasurable and fun aspects of sexuality.

In contrast, “5 Reasons to Fuck a Transguy” depicts a naked transman with safer sex barriers (condom and a glove) and uses explicit language (“fuck” instead of “sex” and “cock” instead of “penis”) and imagery.  For example, in reason #2 we see two people about to engage in strap-on play and in #5 we see a guy that appears to be receiving oral sex or relaxing in a state of post-sex ecstasy.  This sort of language and imagery is absent from the vast majority of sexual health promotion materials aimed at a wide variety of populations.  Thus, in “5 Reasons to Fuck a Transguy,” safer sex is not presented as distinct and separate from sexual pleasure.

Second, the material uses an embodied approach to highlight differences between trans and cisgender men while at the same time eroticizing that difference.  Starting with reason #1 (“trans guys are hot”) we are invited to see the transmale body as the object of desire.  Reasons #2, #3, and #4 call attention to the physical differences between cisgender and transgender male bodies and eroticizes the latter by emphasizing interchangeable cock sizes, more holes to penetrate, and smaller hands for fisting (or using the whole hand for penetration).  Finally, reason #5 alludes to a fetishization of transmen: the transgender body incites curiosity that will ultimately pay off in enhanced pleasure.

Not everyone agrees this is good.  Some posts on Tumblr challenged the idea that transgender men are a sort of erotic “other” or that they will necessarily consent to the activities depicted in the pamphlet:

You better not assume I’m comfortable using the one that “other” guys don’t have and you better not assume that being a guy means I’d be up for being fucked in the ass, either. Go fuck yourself and make your own goddamn third hole.

The “your dick can be any size you want!” argument is like telling a female-identified survivor of breast cancer who’s had a mastectomy “your tits can be any size you want!”

Just because I don’t have my own natural cock doesn’t make me this insane sex toy thing that’s such an anomaly and such a fetish object and so very very strange and different.

So, despite the disclaimer that “every transguy is unique,” some viewers saw the material’s approach as a problemtic eroticization of their bodies and gender.

In sum, “5 Reasons to Fuck a Transguy” moves beyond typical sexual health promotion approaches to include desire and pleasure, but doesn’t avoid the problem of sending its own cultural messages about gender, bodies, and desire, ones that may be problematic from an entirely different point of view.

Christie Barcelos is a doctoral candidate in Public Health/Community Health Education at the University of Massachusetts Amherst.