Abortion and Suicide: A Spurious Link

In South Dakota, it is now legal to require doctors to tell women seeking abortions that they are putting themselves at risk for suicide.

This move is brilliant from a PR standpoint. Unlike banning certain types of abortions entirely or, say, forcing women to undergo invasive screenings that are medically unnecessary, this seems completely apolitical when you first look at it. Don’t people deserve to be informed if they may be increasing their risk for suicide? Don’t we all agree that suicide is a Bad Thing?

However, something tells me that this is actually another attempt to scare women out of (what should be) a normal, socially acceptable medical procedure.

First of all, the inconvenient truth here is that credible research consistently shows little or no link between abortion and poor mental health. One 2008 study reviewed the literature and found that the only studies that seemed to show such a link had very flawed methodology, whereas the studies that were well-designed showed no links. (Damn liberal academics!) And here’s another study that showed no such links. And here’s a thorough debunking of a study that did claim such links:

Most egregiously, the study, by Priscilla Coleman and colleagues, did not distinguish between mental health outcomes that occurred before abortions and those that occurred afterward, but still claimed to show a causal link between abortion and mental disorders.

In other words, that study actually tried to use mental health pre-abortion to confirm a hypothesis about mental health post-abortion. This is simply not how you do science. And it’s especially bad here, because according to the American Psychological Association, guess what the best predictor of mental health post-abortion is?

Across studies, prior mental health emerged as the strongest predictor of postabortion mental health. Many of these same factors also predict negative psychological reactions to other types of stressful life events, including childbirth, and, hence, are not uniquely predictive of psychological responses following abortion.

That’s right. Shockingly enough, the best predictor of mental health is, well, past mental health. And poor mental health predicts poor response to all sorts of stressful events, of which abortion is only one example. Another one being, for instance, childbirth!

Compounding the bad science here is that, unlike physical side effects,suicide isn’t something that just happens to you suddenly and without warning. People don’t just suddenly wake up one morning and decide to kill themselves. Suicidality is a complex process that involves factors like genetics, family history, environment, social support, mental illness, and life circumstances. For instance, here are some things that, according to research, actually increase one’s statistical risk for suicide:

As you can probably surmise, not all of these correlations are also causations. While mental illness and drug addiction can actually cause suicidal behavior, being intelligent and being LGBT probably cannot. In the latter case, the causative culprit seems to be (surprise surprise) institutionalized discrimination and homophobia. Before I get too off-topic, let me point out the irony in the fact that, despite this well-known risk faced by LGBT youth, I don’t see any of these pro-lifers advocating for an end to homophobia.

That’s why something tells me that nothing about this court ruling actually has anything to do with suicide prevention.

Although the court’s ruling does at least acknowledge that abortion probably doesn’t cause suicide, it nevertheless states that “conclusive proof of causation is not required in order for the identification of a medical risk.” This is probably true, but it only makes sense from a physical health standpoint. If studies show that people who get a certain elective medical procedure are much more likely to, say, experience headaches or nausea or numbness, you don’t necessarily need a causative study to conclude that there’s a reasonable chance that these symptoms were caused by the procedure (assuming, of course, that there was no illness present that might be causing them). Furthermore, there’s a difference between saying “This procedure may cause you to experience cramps and headaches” and saying “This procedure may cause you to kill yourself.”

The truth is, mental health doesn’t work that way. A person who gets an abortion might experience mental side effects because of the stress of having gotten pregnant accidentally and been forced to decide what to do, perhaps without the support of a partner or family. Furthermore, any invasive medical procedure can be stressful and worrying for many people–especially one like abortion, which is consistently portrayed as more painful and dangerous than it really is.

And this is all made even more complicated by the fact that the faulty studies in question were actually studying mental health before the abortion. Perhaps a person with poor mental health is more likely to seek an abortion in the first place–say, if they feel that they aren’t mentally capable of raising a child at the moment.

Ultimately, decisions about what to tell a patient should be left up to the people who know most: doctors (with, of course, a reasonable amount of regulation to prevent malpractice). If a doctor can tell that a person seeking an abortion is going through a lot of mental distress, then that doctor may want to gently recommend counseling and perhaps give out some hotline numbers–and training doctors to recognize signs of mental health troubles is always a good thing.

But doctors should not be mandated to fearmonger to their patients. They should especially not be mandated to serve a pro-life agenda.

Surprise! Elle Magazine Editor Doesn’t Really Care About Eating Disorders

Nope, no Photoshopping. Nothing to see here, move along now.

Confession: sometimes I read women’s magazines. They’re fun to make critique and laugh at.

This time, though, I didn’t even get past the magazine’s front matter before finding something objectionable. In her opening letter for Elle magazine’s August issue, Editor-in-Chief Roberta Myers discusses the recent legislation in the U.K. that would require digitally altered photographs of models to be labeled as such. You can practically feel the derision and dismissal dripping off the page:

So now the National Academy of Sciences is getting into the act, trying to define what ‘impossibly beautiful’ means. In response to legislation pending in the UK to require digitally altered photos to be labeled out of concern for public health, as well as the American Medical Association’s campaign against changing pictures ‘in a manner that could promote unrealistic expectations of appropriate body image,’ two Dartmouth computer scientists proposed a ‘metric’ at a recent NAS meeting designed to rate how much retouched photos have ‘strayed from reality.’ The authors noted that ‘highly idealized’ images have been associated with eating disorders, such as anorexia.

Scare quotes aside, I have the feeling that Myers knows exactly what “impossibly beautiful” means, even if the idea of defining it operationally seems a bit silly. I do think that regulatory measures like these should be approached with a certain degree of healthy skepticism, because government regulation should not be undertaken lightly and without good evidence. But Myers isn’t critiquing it skeptically. She’s sticking her head in the sand and denying that a problem exists.

Furthermore, the regulations don’t even propose to ban severely Photoshopped images, but merely to place labels on them. Is putting an extra little bit of text on the bottom of an image really such a burden for Myers? I think not. Note that some countries are going even further–Israel, for instance, banned the use of underweight models in advertising entirely.

Myers continues:

Yet according to David Scott Rosen, MD…eating disorders are as old as the Bible. They cropped up in popular literature 200 years ago–long before Photoshop but right around the time when John Singer Sargent painted his famous Madame X (Madame Pierre Gautreau), a most flattering oil-on-canvas portrait that left out many a “flaw.”

I couldn’t find a citation for this, but it’s probably true. However, nobody’s claiming that eating disorders exist solely because of unrealistic beauty standards in the media. It’s not like a perfectly healthy young woman (or man, but that’s a slightly different conversation) opens up Elle magazine, sees a picture of a thin model, and immediately starts starving herself. Eating disorders arise from a complicated interaction of genetics, family life, and the surrounding culture. They involve complex cognitive processes, such as the ones described in this study. As another example, research shows that people determine attractiveness based on what they have seen the most. So if you’ve been looking at images of impossibly thin women for your entire life, that may be what you’re going to find attractive–and that’s what you may aspire to be.

We can’t prevent genes that predispose one to eating disorders from being passed down, and we can’t make it illegal for parents to teach their daughters that their appearance is the most important thing and that one should use unhealthy means to maintain it (though, with more education, we might be able to prevent that). We can, however, place restrictions on the images that permeate our media.

Furthermore, Myers conveniently ignores the fact that eating disorders have been growing more and more prevalent over the past century, especially among young women. Studies have also shown possible links between media that promotes thinness and eating disorders. It is impossible to establish a causative link with certainty, but that’s because 1) nothing is ever certain in science, and 2) we live within a culture that promotes and glorifies thinness. You can’t really evaluate phenomena like this accurately when you exist within the system that you’re trying to evaluate.

But luckily, studies done with non-Western cultures are very revealing. One extremely compelling study showed that girls in Fiji, who previously had little exposure to Western media, became much more likely to show signs of disordered eating after watching Western television shows for the first time.

Several Google searches brought up countless studies like these. Myers seems to consider them irrelevant here. She continues:

My point is that trying to define “impossible beauty,” and then regulate its dissemination by putting warning labels on retouched images, seems rather preposterous. You know, my chocolate bar never looks quite as creamy as it does in the ads; cars are never quite that sexy and sleek; and the milk in my cereal bowl never looks quite that white. Oh, wait! It’s not milk at all! It’s some gelatinous concoction meant to look like milk while it stays sturdy under hours of hot lights. Shall we label those photos, too?

This passage is as laughable as it is offensive. First of all, cool slippery slope fallacy, bro. Second, while one may argue over the sleekness of a car or the whiteness of a bowl of milk, it is completely unmistakable when magazines alter photos of models such that they appear to thin to actually be alive.

Third, and most importantly, the comparisons Myers makes are flippant to the point of inanity. The worst thing that can happen in her examples is that one’s chocolate bar isn’t creamy enough. The worst thing that can happen when magazines use Photoshop to excess is that, you know, someone develops anorexia and dies.

As I mentioned, the link between digitally altered images and eating disorders probably isn’t simple. But research is increasingly showing that it is there. It is worth noting that Myers never makes any comments about her own magazine’s use of Photoshop, which tells me that she’s fully aware of what she’s doing and is just willfully playing dumb. She knows. And she’s threatened by it, because things are starting to change.

But she’s not done. She goes on to cite an article in this month’s issue:

I wonder what the National Academy would have to say about the photograph we ran in this issue of novelist and essayist Ann Bauer, who writes so eloquently about growing up “ugly”–bearing a steady stream of abuse about her looks from classmates, strangers, and even lovers.

This bit confirms for me what I already suspected–that magazines like Elle print articles like this solely from the purpose of distracting people from the role they play in upholding our society’s beauty standards. These magazines can trot these articles out as examples of their commitment to portraying “women of all shapes and sizes,” when, in fact, they use these women as tokens.

The article in question is indeed a beautiful article. But what’s ironic is that Myers doesn’t even realize how magazines like her own have contributed to the bullying and abuse that women like Bauer face. Of course, people have always valued beauty and mistreated those who are deemed “ugly.” But lately, the box into which women must fit in order to be considered beautiful has been shrinking, whereas the “ugly” box has been growing. Magazines like Elle may not be the only (or even the main) causes of this trend, but it would be naive not to implicate them in it.

Furthermore, that photo of Bauer that Myers is so proud to have featured? It takes up one corner of a page and measures about two by three inches. Compare this to the dozens of full-page Photoshopped models in the magazine.

The most telling (and touching) part of Bauer’s piece, to me, is the end, in which she describes visiting Hungary with her husband and going to the opera in Budapest:

I turned and found myself looking into a full-length mirror. And I saw something I’d never seen before: myself, in a sea of women who looked just like me.

[...]Everywhere I looked in that lighted glass, there were women with large features, deep-set eyes, rounded cheeks, riotous hair, and delicate-yet-meaty little bodies. We were, in other words, an army of ugly people.

Only, for the first time in my memory, we weren’t. I wasn’t. I was normal, even conventionally attractive. Stylish. Interesting. Sexy. Simply that.

I stood in front of that mirror in the Hungarian State Opera House, watching couples mill. Men holding the arms and hands of dozens of women who could’ve been my sisters, mother, and daughters, tipping their heads back, kissing them lightly, gazing with naked admiration at faces like mine.

Bauer shows, ultimately, that she is not ugly. It is American culture that makes her out to be so. In Hungary, women who look like her are not bullied. They are not sent anonymous emails about how ugly they are. They are not denied jobs or pressured to lose weight and get plastic surgery.

This makes Myers’ stubborn refusal to examine the potential effects of her magazine even more ironic (and upsetting). Magazine editors seem to feel that they are being solely blamed for the devastating experiences of many women (and, increasingly, men), but no informed researcher or critic would say that magazines directly cause eating disorders. We have to examine this phenomenon as a system of interacting elements–the mass media, politics, families, and individual brains and bodies–in order to begin to understand how to prevent unhealthy beauty standards, poor body image, and eating disorders.

We can’t start without making sure that everyone knows that the images they see around them every day of their lives are not realistic. They’re not something to aspire to, because they cannot be obtained–except perhaps at a very high cost.

The editorial this photo belongs to is totally unironically called “The Surreal World.” Photo credit: Elle August 2012

“Vagina” is Not a Four-letter Word

You would be forgiven for assuming that our elected politicians are mature adults who can handle using words that designate genitalia. You would especially be forgiven for assuming that given that many of these politicians are very eager to legislate what can and cannot be done with genitalia.

However, you’d be wrong.

This is old news now for anyone who follows these things, but in case you don’t, here’s a recap. On June 14, the Michigan House of Representatives was debating a new bill that would severely limit a woman’s ability to get an abortion by placing new restrictions on abortion providers. The bill passed the House and will go to the Senate most likely in September. (They were also debating a separate bill, which did not pass, that would’ve restricted all abortions after 20 weeks, with no exception for rape or incest).

In response to this, Representative Lisa Brown (three guesses which party) gave a speech in opposition and said, “I’m flattered that you’re all so interested in my vagina, but ‘no’ means ‘no.’” You can see her speech in its entirety here.

The shock! The horror! Brown was quickly forbidden from speaking on the House floor by Republican leadership of the House. A spokesman for Republican Speaker of the House Jase Bolger said, “House Republicans often go beyond simply allowing debate by welcoming open and passionate discussion of the issues before this chamber…The only way we can continue doing so, however, is to ensure that the proper level of maturity and civility are maintained on the House floor.”

To that end, Republican Representative Mike Callton said that Brown’s remark “was so offensive, I don’t even want to say it in front of women. I would not say that in mixed company.”

What Bolger, Callton, and the rest of these concern trolls apparently do not realize is that language is malleable and entirely based on context. In general, words might be inappropriate to say for three different reasons:

  1. They are derogatory and hurtful slurs (i.e. the n-word, fag, retard)
  2. They have been designated as “profane” by our society (i.e. fuck, piss, shit, cunt)
  3. They refer to things or functions that are generally considered inappropriate for polite conversation (i.e. penis, vagina, feces)
These three categories of Bad Words operate in different ways. The first category is inappropriate to say basically always, unless, in some cases, you belong to the group targeted by the slur, or you are using the word in a conversation about the word (but even that is controversial).

The second category are words that are usually used to make a statement. They are much more frequently okay to use than the words in the first category. That’s why when people curse, they use these words. That’s why many writers, such as myself, use them for effect. They’re generally okay to say around your friends, but many people avoid using them in front of people they don’t know well.

The third category comprises words for things that we usually avoid discussing in polite company without a good reason. You wouldn’t exclaim, “That looks like a penis!” in front of your grandma, and you wouldn’t say, “My vagina feels funny” in front of your boss (I mean…unless you have a very open-minded boss/grandma). It’s not the words themselves that are “bad,” it’s the fact that you usually shouldn’t talk about the things those words refer to if you want to be polite.

But all of this falls apart when the context demands discussion of such topics. If you’re at a doctor’s appointment and the doctor needs to tell you something about your penis or vagina, it would be laughable for him or her to avoid using those words. If you’re negotiating sex with a partner, you shouldn’t have to worry that he or she will be offended if you use those words. And if you’re attempting to legislate what women can and cannot do with their private parts, you’re going to have to face the fact that those parts have names.

The most ironic thing here, though, is Callton’s remark about the word “vagina”: “I don’t even want to say it in front of women.” First of all, that’s patriarchal as hell; women can handle naughty words just as well as men can. Second, it’s not just a naughty word; it’s a word for a thing that (most) women experience on a constant basis.

Some conservatives have apparently made a slightly more legitimate criticism of Brown in that she connects restricting abortion with rape (via her “no means no” allusion). I say “slightly more legitimate” only because, having once been a pro-lifer, I understand how they would take offense.

After all, pro-life politicians do not wake up in the morning thinking, “Yo, I’m gonna take away some rights from women and tell them what to do with their own vaginas today.” They think, “Abortion is murder and I have a duty to stop it just like I would stop the murder of a child or adult.” To them, drawing any parallels whatsoever between restricting abortion and committing sexual assault would naturally seem preposterous. It is only those of us who couch the debate in the language of personal liberty who see the similarities.

That’s why this whole incident really highlighted for me the divisions between liberals and conservatives on the matter of reproductive rights. It’s not even just that they can’t agree on whether or not abortion should be legal; it’s that they can’t agree on what abortion is, and on the terms with which the debate should be framed. Liberals say abortion is a woman’s right over her own body; conservatives say it’s the murder of an unborn human being. How can we ever reach a consensus if we define our terms differently?

I don’t know how to solve this problem–and if I did I would probably be the savior of American politics–but at least this story has a partially-happy ending. Brown and several of her colleagues performed the play The Vagina Monologues with its playwright Eve Ensler on the steps of the statehouse last Monday night as a tribute to our right to speak the names of our own body parts. About 2,500 spectators came to watch.

But as for the bill that the House passed, that’ll go on to marinade in the state Senate, which currently has 26 Republicans and 12 Democrats. I’m not getting my hopes up.

How Not to Argue Against Abortion

Our campus magazine, North by Northwestern, recently did a cool feature called “Dormroom Debate” in which it pitted a conservative and a liberal against each other to discuss the recent Arizona abortion laws.

I think that it’s great to expose yourself to dissenting viewpoints, not just for the sake of understanding and kumbaya (though that too) but so that you can learn how to better counter them.

However, just from glancing over the article, you’ll see a problem–both of the writers are men.

Now, as a disclaimer, I don’t see anything wrong with men discussing issues like abortion and contraception. I don’t think that having a penis and/or lacking a vagina makes you unqualified to even talk about these things. I do think, however, that it’s more difficult to have a well-informed opinion on these things if you’re a man. Why?  Because it means you have to take extra efforts to learn about things that women already know by default, such as how hormonal birth control actually works.

What I do think is downright wrong is the fact that women are continually being left out of conversations about their own bodies. It happens in congressional hearings, and it’s happening–albeit to a much less drastic and harmful degree–in our own campus magazine.

I’ll grant that this particular “panel” only involved two student writers, so it’s almost certain that women were left out of it entirely by accident. However, considering that Northwestern has slightly more women than men, and the school of journalism is even more skewed towards women, I find it very unlikely that the editors of NBN could not have produced at least one woman to participate in this debate.

What bothers me much more than the fact that NBN chose two men to discuss what women should and should not be able to do with their bodies, however, was the content of the conservative writer’s piece. Now, obviously, I knew from the get-go that I was going to disagree. However, I expected an entirely different line of argument.

For instance, as a conservative, you can make the argument that abortion laws should be left up to the states. You can make the argument that these laws make restrictions on abortion without actually taking away the right to get one. You can make the argument that these restrictions are necessary because they actually make abortion safer. You can even make the argument that abortion is morally wrong because you believe that life begins at conception.

You can make all those arguments, and I’d disagree with all of them, but they would at least be legitimate, logical arguments. Up until the end, the arguments that the conservative writer was making were mostly these. But then:

Opponents of this law do not really prioritize women’s health and their right to choose. Instead of wanting women to make smart decisions for themselves, they become “pro-abortion.” Their ultimate goal is the slaughter of innocent babies, so women can maintain their more comfortable lifestyles rather than live with the results of their choices — both the trials and the blessings.

Reread this: “Their ultimate goal is the slaughter of innocent babies.”

I’m going to go line by line now:

“Opponents of this law do not really prioritize women’s health and their right to choose.”

There is absolutely no evidence for this claim. None whatsoever.

“Instead of wanting women to make smart decisions for themselves, they become ‘pro-abortion.’”

Classic strawman fallacy. If indeed there are any pro-choice advocates who think that abortion is a “good” thing, or even that it is a decision to be made lightly, they can only be a tiny minority. In fact, the liberal writer in this piece explicitly states, “I believe every abortion is a tragedy.” Why not take him at his word?

“Their ultimate goal is the slaughter of innocent babies…”

Do I even need to say anything about this?

Just in case, I will anyway. Because there is no scientific or legal consensus regarding when life begins, individuals are free to define it for themselves as they choose. Those who believe life begins at conception probably would not choose to get an abortion. But those who believe that life begins at birth (or at the third trimester) do not believe that abortion is murder. Therefore, accusing them of promoting “the slaughter of innocent babies” is unfair. In other words, because there is considerable ambiguity in the definition of life’s beginning, it’s quite intellectually disingenuous to accuse those who disagree with your personal definition of advocating murder. Also, hello appeal to emotion.

“…so women can maintain their more comfortable lifestyles rather than live with the results of their choices — both the trials and the blessings.”

This statement shows a stunning lack of understanding of why women might choose to get abortions. First of all, statistically, most women who find themselves in that situation never had “comfortable lifestyles” to begin with. They tend to be young, single, and working-class. A woman who winds up accidentally pregnant is likely to be someone who didn’t have sufficient access to contraception–or, more tragically, a victim of sexual assault.

Second, the wording of this sentence clearly shows that the writer considers pregnancy, childbirth, and child rearing to be an acceptable consequence for a woman’s “choice”–meaning, obviously, the choice to have sex. Since I’m guessing this writer is someone who believes that sex should be for procreation only, there’s little I can really say in response except that, guess what, that’s not how the vast majority of people see it anymore.

I’m neglecting something here, of course. This writer made it clear from the very beginning of his piece that he’s not basing his arguments on logic or on conservative political ideology at all. At the very beginning, he writes:

My dad is a confessional Lutheran pastor, my mom a parochial school teacher, and I went to a Lutheran High School. Because of this upbringing, I have a strong belief in my innate sinfulness and need for my Savior, Jesus Christ. My faith is the primary foundation for my political ideology and is why I would say I’m a pretty staunch conservative all around. I believe that we should be good stewards of the blessings God has given us and we should live in a way that is pleasing to Him.

That’s right. He comes right out and says that the basis for his political beliefs is his religion–a religion that is legitimate and meaningful to him, but a religion that not all of us share.

Political arguments must not be based on religion. We have separation of church and state for a reason.

A Handy List of Ludicrous Anti-Abortion Legislation

For your reference. I’ll try to update this as needed. Read the linked articles for more information about these bills and why they are so harmful.

  • Oklahoma State Bill 1433–defines a fertilized egg as a “person” and seeks to extend human rights to said “persons”; conflicts with Roe v. Wade.
  • Georgia House Bill 954–bans all abortions after 20 weeks, even in cases of rape and incest, unless the woman’s life or health was threatened (this last exception was only added later); also conflicts with Roe v. Wade; this is the bill that a George state rep defended by comparing women to lifestock.
  • Mississippi House Bill 1390–would close the state’s last remaining abortion clinic on a technicality to “prevent back-room abortions.”
  • Arizona House Bill 2036–bans all abortions after 20 weeks because, according to lawmakers, that’s when fetuses begin to feel pain (which is false); conflicts with Roe v. Wade; defines fetal age as beginning at fertilization–up to two weeks before a woman’s last period, which is how fetal age is usually calculated. So really, it’s after 18 weeks, not after 20 weeks like the other dumb bills.
  • Mississippi Senate Bill 2771would make all abortions performed after a fetal heartbeat can be detected illegal; doctors who perform such abortions could serve up to 30 years in prison. Women seeking abortions would be forced to undergo an invasive transvaginal ultrasound to check for a heartbeat, which can be detected just 6 weeks after gestation.
  • Alabama Senate Bill 12–would have mandated all women seeking abortions, even victims of rape and incest, to undergo a transvaginal ultrasound and view the image. Why? To help “a mother to understand that a live baby is inside her body.”
  • Virginia House Bill 62–slashes state funding for low-income women who are pregnant with complications and need abortions.
  • Arizona Senate Bill 1359–allows doctors to withhold information from pregnant women that may cause them to seek an abortion (such as fetal abnormalities) by shielding them from potential lawsuits.
  • Kansas House Bill 2598–same as above, plus a bunch of other restrictions for good measure.
  • H.R. 2299–would prevent women under 18 from crossing state lines to get an abortion without their parents’ consent.
  • Tennessee House Bill 3808–would create an online list of the names and addresses of all abortion doctors. Not insignificant given the recent bombing of a Planned Parenthood clinic in Wisconsin.

One note–I’ve chosen not to attempt to find updated information on how these bills did in HRs and Senates, first of all because that would take all of my time, and second because that’s not the point. Some of these bills passed, some of them are still being deliberated. Point is, none of them should’ve made it onto the floor to begin with.

Another note–I stopped writing this post not because I was unable to find any more bills, but because I just got tired and sad from looking at them.