“Should We ‘Fix’ Intersex Children?”

M was born with genitals that were not clearly male or female. Also known as disorders of sex development (DSDs), the best guess by researchers is that intersex conditions affect one in 2,000 children.

The response by doctors is often to carry out largely unregulated and controversial surgeries that aim to make an infant’s genitals and reproductive organs more normal but can often have unintended consequences, according to intersex adults, advocates and some doctors.
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A long and gut-wrenching list of damaging side effects—painful scarring, reduced sexual sensitivity, torn genital tissue, removal of natural hormones and possible sterilization—combined with the chance of assigning children a gender they don’t feel comfortable with has left many calling for the surgeries to be heavily restricted.

Find the full article at The Atlantic. Also a find here a post by Ellen Feder on the same case (IJFAB Blog, for the record, way ahead of The Atlantic on this one).

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Gay Teacher Fired for Getting Married

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Apparently this is still considered constitutional. Especially bizarre is that they knew he was gay when they hired him. I mean, huh? Find the story at NPR.

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Does a womb make you a woman?

By Katy Fulfer and Angel Petropanagos

At the recent FABWorld Congress in Mexico City, a panel on Ethics of Uterine Transplantation outlined three ethical challenges.

  1. Ariel Lefkowitz and Jacques Balayla, authors of the Montreal Criteria for Ethical Feasibility of Uterine Transplantation, suggested that only genetic females are suitable candidates for uterine transplantation, given the lack of non-human and human research trials on genetic males. However, the authors do not think that transwomen lack genuine desires to experience gestation, but rather, that the research needs to catch up before the surgery can be ethically offered to them. Indeed, uterine transplantation (in conjunction with other ARTs, like fertility preservation and IVF) can be important for helping both trans and cis women to satisfy their reproductive desires/achieve pregnancy.
  1. Timothy Murphy reviewed and rejected philosophical arguments that would discriminate against transwomen as candidates for uterine transplantation. Murphy argued for two significant identity claims: first, uterine transplantation is one way for a transwoman to physically affirm her identity as a woman. Second, uterine transplantation contributes to transwomen’s social gender identities in helping to “close the gap” between transwomen and ciswomen.
  1. Mianna Lotz raised concerns about the biological bias in favour of the gestational relationship (and in many cases genetic ties) that can unduly compel some women to choose uterine transplantation, despite the risks and uncertainties associated with uterine transplantation. (See Angel Petropanagos’ Impact Ethics blog post for a brief review of some of the medical and ethical challenges of uterine transplantation.)

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Boob Jobs and Feminism

In her article “I’m a Feminist and I Got Breast Implants” (full article here), beauty expert and journalist Grace Gold asks, “Why are women judged and even ostracized by both feminists and the greater public at large if they choose to have cosmetic surgery?”

Gold claims that she wanted a 34C cup because she “wanted in on the fun” of having boobs, and due to her personal aesthetic preferences (she loves Marilyn Monroe, for example). These are fine personal reasons, but I think the stigma should end for women that decide to get breast augmentation surgery for any reason, even for the ‘bad feminist’ reasons, e.g. in order to get more male sexual attention (Gold says she feared being deemed a “victim of patriarchy”), because we live in a patriarchal society. When a woman decides to conform to certain beauty standards within that patriarchal society, she is simply trying to gain access to power in a way that is available to her, when there exist many other routes that may seem – or may very well be – unavailable.

pfizer viagra generic Juvenile Rheumatoid Arthritis is the RA arising in children below the age of 16. On the other hand who prefer medical guidance, enjoy their love-life levitra buy generic to the fullest. In my case, because I saw unica-web.com viagra ordination the guy standing next to me while I was talking to the girl, I escalated very carefully which is why the guy was totally cool. Remain calm while driving with your teen, and focus on constructive ways to focus cipla india viagra on their driving more effectively. Gold’s article explains how the stigma of breast augmentation surgery has led to a dangerous situation for those seeking the procedure: “There is no public empathy or advocacy for the cosmetic surgery patient. When something consistently goes wrong in other areas of medicine or on the consumer market, there’s a big outcry, and regulations are passed to protect the patient and buyer. Yet when the worst possible scenario happens to someone getting liposuction or a butt lift, it’s all too common to hear people essentially say, ‘She got what was coming to her’.” Gold goes on to liken this rhetoric to the slut-shaming rhetoric that denounces rape victims. While this comparison may be problematic, Gold makes excellent points here and throughout her essay.

Until the stigma surrounding breast implant and other cosmetic surgeries ends, there will be little advocacy for surgery patients, and we need advocacy in order to change the system. Many women will continue to get botched boob jobs until this happens. Gold is right: botched boob jobs, as well as the general and feminist stigmas surrounding breast implants, are problems for feminism. What are your thoughts?

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“ASU professor encourages students to defy body hair norms”

Female student participants stop shaving their legs and underarms for ten weeks during the semester while keeping a journal to document their experiences. For male students, the assignment is to shave all body hair from the neck down.

“There’s no better way to learn about societal Pain from this injury is a result of a misalignment in the spine that is causing a cialis online store nerve compression. The dosage pattern should be taken up by the doctor and do not take the pills from a friend s reference as the pill is always given as per the person s body and how far order viagra usa the disorder has affected the man. These foods provide energy, allow sildenafil generic from canada proper blood circulation and enable in healing male disorder. If you have over exerted yourself due to exercise this medicine for viagra buy germany the first time. norms than to violate them and see how people react,” said [Professor Breanne] Fahs. “There’s really no reason why the choice to shave, or not, should be a big deal. But it is, as the students tend to find out quickly.”

Find the story here.

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PURO VALOR MEXICANO EN EL MUNDIAL DE FUTBOL

En la copa mundial de de Brasil vimos algo más que futbol. Entre la emoción de ganar y la decepción de perder presenciamos la actuación de los mexicanos, no solo de los futbolistas, sino de nuestros compatriotas mostrando que en nuestro país los hombres son muy hombres. Hubo de todo, como extraído de un manual titulado “Cómo ser un hombre de verdad aunque puedas morir en el intento”.

El futbol se ha convertido, o tal vez siempre ha sido, una celebración de la masculinidad que exacerba expresiones como el machismo, el sexismo y la homofobia, pero en esta ocasión, los aficionados mexicanos, se llevaron la copa mundial. Una muestra de ello es que del total de personas detenidas a lo largo de la justa, la mayoría fueron hombres de nuestro país. A algunos les puede parecer gracioso, pero si atendemos a tres casos particulares, en realidad tendríamos que preocuparnos y mucho, por la forma que está tomando la masculinidad mexicana. Es motivo de alarma, si consideramos que el machismo, el sexismo y la homofobia constituyen un mismo fenómeno, que explica la mayor parte de los actos violentos de los hombres contra las mujeres, contra otros hombres y contra sí mismos. Tratemos de verlo como si se tratara de una pieza teatral en la que se está escenificando la masculinidad:

Primer acto, 13 de junio:  México juega contra Camerún, y los hinchas mexicanos exhiben su tradicional grito de − ¡Puuuto!− dirigido al guardameta del equipo contrario, un acto que, aunque practicado en nuestro país desde 2003, es claramente homofóbico y misógino. Independientemente de que el grito no se dirija a un homosexual, la intención la entendemos y es ofender al contrario señalándolo como tal, con lo que se está asumiendo que un hombre de verdad es solo aquél que no se porte como mujer, que no sea gay.
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Segundo acto, 18 de junio: En una dramática actuación y a puro valor mexicano, un joven de 29 años, saltó de un crucero en el que viajaba con cientos de paisanos que seguían la ruta de juegos de su selección. Como parte del cortejo que dirigía a una chica, incluyó este acto machista para mostrarle que él era un hombre de verdad, muriendo en el intento. Su cuerpo no ha podido ser encontrado en el mar de Brasil.

Tercer acto, 29 de junio: En una perfecta actuación mexicana, un panista y servidor público de la Delegación Benito Juárez, se tomó la libertad de tocar los glúteos de una brasileña que caminaba por la calle al lado de su esposo. Ante el reclamo de éste, el acosador y tres amigos que lo acompañaban, le propinaron una paliza que lo dejó inconsciente. Hoy los cuatro están detenidos en una prisión brasileña con el riesgo de seguir encerrados durante 8 años. En esta actuación estelar, el acosador ejerció violencia contra una mujer, contra otro hombre y contra sí mismo; es un ejemplo de una masculinidad que combina sexismo, misoginia y machismo, y que cada vez es más frecuente en nuestro México, enfermo de una guerra entre hombres que a diario se la juegan a puro valor mexicano. ¿Hasta cuándo?

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This July 4th, Here’s Hoping For More Freedom To Access American Healthcare Options

International readers will, I hope, both forgive and find value in this Amerocentric reflection on health care and freedom as America celebrates its Independence Day this July 4th (and the day after, and the day after that). It bears reflecting on what freedom means: freedom to what, freedom from what? And also on what happens when freedoms conflict with each other.

A healthcare provider’s stethoscope, its flexible tubing colored a bright red, lays atop an American flag with its red and white stripes, and blue field covered in white stars.

A healthcare provider’s stethoscope, its flexible tubing colored a bright red, lays atop an American flag with its red and white stripes, and blue field covered in white stars.

 

In 2011, in celebration of America’s July 4th Independence Day holiday, Johns Hopkins University’s Berman Institute of Bioethics featured an op-ed about James Richard Verone, “the luckless North Carolina man who ‘robbed’ his local bank… just to get arrested so he could access health care in jail.” This LA Times article details the constraints in which he believed himself to be trapped as an uninsured, unemployed (after many years of steady work) 59-year old who was years away from qualifying for Social Security payments or Medicare coverage which he had earned through paycheck taxes. Verone got himself a criminal record to no avail: his actual sentence for larceny did not carry a long prison term that would hold him over until he might be eligible for his earned benefits, but a much shorter one. To paraphrase the final sentence of that piece, we have reached the breaking point when Americans are willing to trade in their freedom for healthcare.

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Minimally Conscious States

One typically thinks of advances in medical science and technology as unalloyed benefits. The ability to cure illness, mitigate pain, and make more accurate diagnoses are some of the uncontroversial results of medical progress. Yet as a new study of vegetative states demonstrates, such advances can raise ethical quandaries for physicians and the families of patients diagnosed as vegetative. The study, conducted in Belgium and published in the British medical journal, Lancet, showed that using the brain-scanning technique known as positive emission tomography (PETs) provided a more accurate neurological assessment than other devices, such as MRIs. The assessment provides more information about “minimally conscious” states, originally thought not to exist in such patients.   Evidence from recent research demonstrated the existence of minimal consciousness in vegetative patients, but without the details that emerged in the Belgian study. It revealed that not only do patients who are minimally conscious have some level of awareness or responsiveness, but they may have some chance of improving to regain higher levels of consciousness.

Why does this new research pose ethical quandaries? Aside from the acknowledgment by a researcher in the Belgian study that the diagnostic technique is not ready for routine use, a bigger problem is uncertainty in its ability to predict significant improvement or recovery. This can lead to “false positives”–diagnoses that show minimal consciousness and a prospect of improvement in brain function when that will not occur. This situation produces uncertainty among medical experts and families hopeful that their loved one will recover cognitive function. As the Belgian researcher stated, “We shouldn’t give these families false hope.” In such circumstances, both physicians and families may be unlikely to remove life supports even after a significant time has elapsed, creating anguish about whether and when to “pull the plug.” Until recently, the problem of uncertainty was that of “false negatives”: diagnoses that patients in a vegetative state had no consciousness at all when, in fact, they may have been minimally conscious. With the new study, uncertainty about eventual improvement looms as a barrier to timely decision making. It is often the case that lingering uncertainty is worse for people who have to make decisions than receiving a bad prognosis that is definitive. Continue reading

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“Why I Went To The Men’s Rights Conference”

From feminist journalist Kelsey Miller:

As a web writer and a feminist, I can’t avoid reading about the Men’s Rights Movement, nor the vitriolic and often violent discourse that’s risen up around it. In the years since it’s gained footing in mainstream consciousness, with representation in SNL sketches and parallels drawn to the Elliot Rodger shooting, the discussion around this movement has become even louder, angrier, and that much more confusing. What do these guys want exactly? Can they honestly believe men to be a trod-upon minority? Do they really think feminism is “an empire of evil?” The answers seemed both emphatic and convoluted, and I knew enough to know there must be more to the story. There was — but, if anything, it’s even sadder than we thought.

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This is a strange phenomenon. Find the whole article here.

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The Pendulum Swings? Spain faces a return to an era of very restricted access to abortion

This pen-and-ink image shows the trace of a pendulum swinging back and forth, the middle blurry and only the extremes of the swing clear. Image Credit: “Pendulum Swing”, by DK Osorio

This pen-and-ink image shows the trace of a pendulum swinging back and forth, the middle blurry and only the extremes of the swing clear. Image Credit: “Pendulum Swing”, by DK Osorio

 

In 1985, Spain passed laws restricting a woman’s right to abortion, the so-called “Organic Law” governing reproductive health and abortion. Under this law, abortion was legal in only three cases: serious risk to physical or mental health of the pregnant woman, in which case abortion was supposed to be therapeutic; rape; and the presence of malformations or defects in the fetus. No other reasons were allowed for legal abortions taking place in Spain. Those seeking abortions needed the wherewithal to leave the country. Both pregnant women who procured abortions, and medical personnel who performed them, could be imprisoned for doing so (this was apparently rare, but possible).

In 2010, after decades without a right to seek abortion for any reason other than health, rape, or fetal deformity, a revision to the Organic Law went into effect and Spanish women were finally given a right to so-called “abortion on demand.” Debate over the passage of the law heavily involved the notion that access to safe abortion was a matter of reproductive health. As of March 3, 2010, up to 14 weeks gestation, Spanish women can now choose to terminate the pregnancy for any reason. Within that time period, abortion is wholly decriminalized (for context, most U.S. states allow abortion for any reason up to anywhere from 20-24 weeks; some have proposed 14 week cutoffs but those are still in development because of the 1973 court case Roe v. Wade, which made it a matter of federal case law that states could not make abortion wholesale illegal until after the point of “viability”). Abortion can occur up to 22 weeks if there is a serious risk to the life or health of the pregnant woman or fetus, and thereafter only if fetal anomalies incompatible with life, or some other serious and incurable fetal disease, are detected. According to Spain’s own Ministry of Health, these abortions up to 14 weeks gestation constitute over 90 percent of all abortions carried out in Spain in 2012, the remainder of which involved medical grounds for termination later in pregnancy. The rights of women in Spain to access abortion without fear of prosecution were greatly expanded (though it should be noted that rates of abortion did not increase substantially for 2011, and went down in 2012; this is variously attributed to causes including women claiming health risks for any unwanted pregnancy prior to 2010, and to increased availability of the morning after pill at the same time the new law took effect).

The ire of Spain’s conservative religious and political forces was roused.   Indeed, a large rally of several tens of thousands of people protested against the 2010 law in Madrid, prior to its passage. Other protests against the expansion of abortion access continue to take place, such as this one in Barcelona in 2012. Continue reading

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Ontological Confusion in the U.S. Courts

Serene J. Khader (Stony Brook University) sends this <span id=

Concurrently, the male sexual organ receives adequate blood to experience erection. generic india levitra If the problem occurs, there should cheapest levitra be a doctor’s supervision. The absolute measure to enhance your durability depends prescription viagra uk upon your body capacity and the degree of impotency capture. The main reason, for not getting proper erection are the natural enzyme – phosphodiesterase viagra canada cost . my way.” width=”880″ height=”440″ /> Serene J. Khader (Stony Brook University) sends this my way.

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Health Reforms in Mexico

Im winding down my time in Mexico City at the FAB conference and the International Association of Bioethics my first ever on both counts. It was exciting to meet so many folks in person, especially at my first meeting of the IJFAB editorial board!

I also had the opportunity to catch up with an old friend who travelled from Morelia to spend the weekend after the conference with me. I went through a Feldenkrais Method training in Mexico with Adriana Delgado, a wonderful contemporary dancer, who at the time (12-16 years ago) was leading a dance troupe in Mexico City that integrated dancers with disabilities.

Catching up with her over the weekend was a delight in itself, and also gave me an interesting perspective on several themes of the conference. Two things we talked about stand out for me.

One was her personal experience of Mexican health reform. At the Congress, we saw no fewer than three current or former ministers of health on the main stage. Julio Frenk was part of a riveting panel with Norm Daniels and Thomas Beauchamp, speaking about Mexicos on-going process of health system reform, with a focus on progressive realization of a human right to health (Daniels) and the role of data (bridging Beauchamp on the need for new models of research ethics) for accountability to the public, to using ethical guidance in health systems reform (Frenks theme). Frenk spoke of social inclusion, equal opportunity, respect for autonomy, social responsibility, and financial justice as the key ethical principles [another unofficial link to the full pdf] that guided the progress the Mexican government has made, starting with his tenure as Minister of Health, on achieving universal health care, as they claim now to have done.

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