A Rant About Human Rights and Sex Work

I recently attended the 10th Annual  Boyle McCauley Harm Reduction Conference. It will take more than one post to organize what I learned, and what the sessions made me think of. Let’s start with this.

On day two, I attended a session about the experiences of sex trade workers in the Fort McMurray area. Darren Seabarran and Jazzy Desjarlais were the speakers. The presentation focused on a survey of female sex workers in the area. The women surveyed were streetwalkers, not escorts. The responses they gave were haunting.

The part that troubled me the most was the part where these women were asked about their fears. The majority of them replied that their top fears were rape, and dying and having no one know that they were dead. This got me thinking about how, in Canada (and elsewhere) we place different values on different lives. In Edmonton over the last several years, many women involved in street prostitution have been brutally murdered.

When Tim McLean was murdered on a Greyhound bus, the nation rose up and clamoured for justice. When another woman involved in street prostitution is abducted, assaulted and murdered, there is a resounding silence. Why is it that we do not scream for justice? Why is it that our society views people involved in sex work of any kind as someone less valuable than the next person?

The Definition of Harm Reduction

I have been a volunteer with HIV Edmonton for about 4 years now. In the time that I have spent at this amazing organization, I have learned a great deal about this wonderful concept of Harm Reduction. It makes perfect sense to me, but many people disapprove of harm reduction, and the controversy rages around us.

Harm reduction can take many forms. For our purposes, we will discuss the most controversial form: drug use. The philosophy of harm reduction assumes that the person who is using drugs is not necessarily going to stop. It is a philosophy of meeting people where they are at in life. Instead of telling them that drugs are bad, the idea is to give them a clean needle. Education, outreach, and health promotion are at the center of this approach. The health professionals involved will provide clean needles to injection drug users, and will educate them about how to keep themselves safe from diseases such as HIV and Hep C. Sometimes, the health professional will help the addict by suggesting a less harmful way to ingest the drug, such as taking heroin in a cigarette rather than by injection.

A wonderful local doctor, who’s name escapes me at the moment once said: Harm reduction is about keeping people alive until they are ready to quit. I think that this is an amazing thing, and there should be no question as to whether these programs are permitted to operate.

Unfortunately, the United State’s War on Drugs has taken the opposite approach. Since Canada is influenced by the USA much more than we would like to admit (and we have a Conservative government at the moment) we are not as enlightened as we could be on this. Some people believe that harm reduction condones drug use. Others believe that it is a waste of time, that addicts put themselves in this position by choice, and therefore must live with the consequences. These approaches deny the fact that drug addiction is an illness that deserves to be treated with the same concern as any other illness. Denying vulnerable people health care services sends the message that some people are expendable. This is not the kind of world I want to live in.

Week 2 Without the Pill

In the last two weeks since going off oral contraceptives, I have noticed a remarkable change to my mental state. I have recorded the things I have noticed below, in point form.

- My mood has improved tremendously. I have energy to get up in the morning again.

- I am sleeping better at night.

- My sex drive has returned. I am more easily aroused, and reach orgasms much more quickly.

- I feel in tune with my body.

- I am inspired to create art again.

- My thinking has grown clear. The brain fog is a thing of the past.

- I have a much better idea of what I want out of life. I feel grounded.

- My armpits smell better.

I know that this information is ‘anecdotal’, but I believe that it requires serious consideration. The medical establishment has a history of not taking women’s medical needs as seriously as men’s. Most drug trials are done exclusively on men. The establishment feels that women’s menstrual cycle makes them unpredictable, and not good candidates for research models. Female specific pharmaceuticals such as birth control pills are not studied as diligently as they should be. This is changing, but it is something we have to be aware of if we are to lead healthy lives.

I will not advise anyone equivocally against taking hormonal contraception. However, I believe that choices should be informed. Since women who are contemplating going on hormonal contraception are not often informed of the potential side effects with respect to mental health, I feel compelled to make it known.

Life After Oral Contraceptives

When I started this blog, I did not expect it to get as personal as it has. After my experience with the pill, I became increasingly aware of what we are not told by the medical community, and how important it is for us to speak out. I may not be a doctor, but I do know my body. The simple fact of telling our truths is essential for creating a healthier future for ourselves and the women and men of tomorrow.

I have been off the pill for over a week now. Much has happened in that time. First, I experienced extreme anxiety and anger in the first few days. I felt betrayed by medicine, I was afraid that my body would never return to normal. I also experienced very powerful sexual feelings, and with them, a fear that I would be unable to enjoy sex again. These fears proved to be false.

After the first few days, I became very creative again. I went out and bought canvas, and created a painting. This is something that happened only once while I was on the pill. I painted a stylized vulva, in honour of my body and sexuality, and the divine feminine. I do not consider myself religious, but if I was, I would definitely be a goddess worshiper. Well, perhaps I am. Either way.

With this rebirth of creative and sexual passion, came insight into my life as a whole. I began to question my reasons for being in the program at school I am in. I have been forcing both my body and my mind into a mold that does not fit me. As a result, I was experiencing a terrible, spirit-numbing depression. I am not in favor of medicating away these feelings, except in extreme circumstances, which left me exploring the why. Why am I feeling this way? What is wrong about my situation? What do I really want to do with my life? What is my calling?

Right before going off the pill, my husband and I went to see a talk with Salman Rushdie, a writer I admire tremendously. During the talk, I began to put the pieces together. Why am I not writing? I asked myself. I have always wanted to write? Why have I allowed my quest for education, status and respectability to cloud my desire to write?

After going off the pill, I withdrew from the college. It has caused me some stress, but it is a manifestation of a very basic need in myself. I still intend to pursue a university education, but I will do so on my own terms and in my own time. Right now, I need to write, heal, and become acquainted with myself again. I am going to find a job, in a bookstore or something along those lines. I am already writing again. I am diving into the craft of words, and taking the time to figure out what I really want out of life. My husband is amazingly supportive of me during this time. He wants me to be happy. That gives me strength. He is also on a crusade to educate every male friend of his about the dangers of oral contraceptives, and convincing them to find alternatives with their partners.

In the next few weeks, I will be putting together a list of reproductive health resources. I will start with my own city of Edmonton, but will do my best to provide resources from all over. It is a daunting task, and if any reader wishes to contribute an organization of interest, I will be very grateful.

The Pill and Depression

There is evidence that taking oral contraceptives can cause depression or exacerbate existing depression in some women. In Christiane Northrup’s wonderful book ‘Women’s Bodies, Women’s Wisdom’, several cases of mental health issues associated with the pill have been discussed. I have also discovered articles discussing doctors who go against the majority of people in the medical establishment and have found evidence of a connection between the two. The synthetic hormones in the pill interfere with the production of serotonin, a mood elevating chemical in the brain. This can be a debilitating condition for some women.

Personally, I have always been prone to depression. I have a significant family history of mental health issues, from mild depression to schizophrenia, and have always been aware that I need to care for myself in this area. I have been on the pill for two and a half years now. My occasional bouts of sadness have transformed into a perpetual state of confusion, hopelessness, and lack of energy. It is as though someone has flicked off a switch in my head.

I do wish that depression was taken more seriously by the medical community. When I went on the pill, they asked me questions about my family and personal history with respect to certain types of cancer, migraine headaches, heart disease, and stroke. They did not ask me about my mental health history. They warned that I might feel ‘tearful and emotional’ for a while. I was not prepared for the sweeping effects of depression on my life. In retrospect, I probably should have inquired about the possibility of long term consequences to my mental health. Honestly, it hadn’t occurred to me. I assumed that they would tell me if that was a significant possibility. I urge you to learn from this!

In the past two years, I have gone from being a prolific writer, to one who can barely keep a blog up to date. I have gone from a motivated student to a listless, barely getting by, student. I have painted one picture in the last two years. Before this, I was a prolific artist. It has become so serious that I can barely drag myself to work and school anymore. I will update this blog with my progress after getting off the pill.

For women who have sex with men and react badly to the pill, there are other options. Condoms, male and female, are easy to obtain and easy to use. Well, the female condom might take a bit of practice. Basically, if you can insert a diaphragm, you can use a female condom. If a barrier method is undesirable, and STIs are not a concern, the IUD can be a viable alternative. Then, there is the option of male or female sterilization (vasectomy in men, tubal ligation or the Essure procedure in women), if you have decided that a permanent method would be the best choice for you. These do come with the possibility of complication, as with any surgery. Some insurance plans will cover the procedure, others will not. All of these methods have their own risks and side effects, but, if depression is a problem, they may be desirable alternatives to oral contraceptives.

Above all, don’t let anyone in the medical community trivialize your concerns about depression and the pill. It isn’t something that I wide variety of doctors like to discuss. If necessary, force the issue, or change doctors. You know your body better than anyone else. After all, you have to live in it!

For more information, here is a link to an article about research in this area:

http://www.aphroditewomenshealth.com/news/hormones_depression.shtml

The Morning After Pill and Abortion are Two Different Things

I have come across the argument that emergency contraception equals abortion several times. This is not a scientific fact. Abortion is by definition the termination of an established pregnancy. Emergency contraception, or Plan B, is a large dose of the synthetic female hormones found in regular birth control pills. This prevents the egg from being fertilized. If the egg has already been fertilized and has implanted itself in the uterus, the morning after pill will not dislodge it. That is why the morning after pill needs to be taken within 78 hours (the sooner the better) to be effective.

It is probably already obvious that I am pro-choice. I see abortion as a necessary health service and a matter of private conscience. I think that it is a sad event, one that would be unnecessary in a perfect world. However, we don’t live in a world of ideals, but one of often sad realities. The bottom line is that I support a woman’s right to govern her own body as she sees fit.

It is ironic that the people who oppose abortion most vehemently also oppose sex education and access to contraception, although these measures reduce the need for abortions! These right wing types also oppose programs that will help mothers who are struggling to raise their children in poverty. It makes me question the ethics of the far right. I think that if someone truly is ethically opposed to abortion, they would want to do something for the women who have chosen to keep their unplanned children. The far right does not have a mandate for life. They simply hate sex, and they hate women. They fear women’s power, and seek to keep her enslaved to her biology.

Nonoxonyl-9: What You Need to Know

Nonoxonyl-9, the active ingredient in over-the-counter spermicides, can put you at an increased risk of contracting STIs. The substance is actually an industrial solvent. It’s first use was to strip graffiti from subway walls. Now, it is an active ingredient in spermicides that are inserted vaginally. This is obviously not good for the woman using the spermicide, or her partner, for that matter. When the vaginal walls are damaged, it is much easier for viruses to enter the body. Besides, who wants an industrial solvent near their cervix? Anyone?

Spermicides, when used alone, are highly ineffective. Methods of contraception that require spermicide vary in effectiveness. The Today Sponge (which is no longer available) was not very effective, and it contained too much Nonoxonyl-9 to be good for you. The diaphragm is more effective, as it is fitted to the individual woman by her doctor. It requires spermicide. If you decide to use a diaphragm, it is good to make sure that you are not at risk of contracting STIs, and that you do not have reactions to the spermicide.

I always recommend condoms, as they are readily available AND offer protection from STIs as well as pregnancy. Yes, they can slip off, but no method of contraception is 100% fool proof. Besides, we have the morning after pill. We do have to keep fighting for our right to emergency contraception, as some extremists believe it to be a drug that causes abortion. I will write on this in greater detail in another post. The bottom line: talk to your health care provider about birth control options. Access to contraception and reproductive health care is a human right.

Why I Hate Sarah Palin

Recently, the student paper at Grant Macewan College printed an article about a Women in Politics forum that the college will be hosting. I think it’s great that women are being encouraged to participate in politics. However, one thing about this article really bugged me. Sarah Palin was touted as a great example for women everywhere. This is dangerous thinking.

Sarah Palin does not represent women simply by being female herself. She does not stand for the issues that will make a difference for women in America. Since Canada is heavily influenced by the United States, her possible elevation to Vice President is a very disturbing proposition.

Most of us know of Mrs Palin’s anti-abortion stance. It doesn’t stop with restricting abortion access. In Alaska, the chief of police, Charlie Fannon, who was hired by Palin, changed the policy for the treatment of rape victims. Before he was hired, the police force included rape kits in the annual budget. Mr Fannon shifted the responsibility for payment from the police budget to the victim. Rape kits are an essential service, as they both provide crucial evidence and screen the victim for any disease she was exposed to during the assault. Palin was in a position to veto Mr Fannon’s decision. She did not fight this at all. Perhaps this is due to her fundamentalist position on issues of reproductive health. Rape kits include emergency contraception, which many fundamentalists believe is the same thing as an abortion. As it stands, if a rape victim cannot afford the $750 USD cost of a rape kit, she will not have the necessary evidence to bring the perpetrator to justice. She might also have to deal with a pregnancy as a result of the assault, which no one should have to endure.

It is worth noting that no other investigation is paid for by the victim or the victim’s family. Robberies, murders, etc, are all covered by tax dollars. Why is rape not included in this list? Why is Sarah Palin being treated like a hero and a friend of feminism when she clearly is nothing of the sort?

To read more about rape kits in Alaska, see this link: http://www.blogher.com/rape-and-justice-wasilla-ak?

Reproductive Rights in Canada: The Conscience Clause

I thought that I would begin this blog by looking at the hypocrisy in the Canadian medical system. I’m sure that most Canadians are aware of the ‘conscience clause’ that allows Canadian doctors to opt out of performing procedures that conflict with their personal sense of morality. Now, when you hear that, you will most likely think of access to abortion. Well, it turns out that abortion is only one of the services that women can be denied by their doctors. I recently read an article about doctors refusing to prescribe birth control to their patients; some even went so far as to deny their female patients annual PAP tests!

According to the law, the doctor opting out of performing a service based on the conscience clause must provide a referral to a doctor willing to perform the service. In theory, this sounds great. In practice, it does not always happen. Some doctors will refuse to refer a patient as an act of protest against the ‘unethical’ medical practice. How is a PAP test unethical? As you know, it is an annual cervical swab that tests for cancer. Cervical cancer is very easy to treat if caught in the early stages. By denying this service, these doctors could endanger the lives of Canadian women. Besides, if you are a doctor, your primary concern should be for your patient’s health, not for advancing a personal crusade. If a person cannot handle performing PAP Tests (or at least referring a woman to someone who can) they have no business in the field of medicine.

Since sexual health is a sensitive subject, women who have faced discrimination in this area are unlikely to speak up. This worries me greatly. The fight for equal rights is fought on many fronts. One that is often neglected is the right to reproductive health care. Why is it that in this day and age women can go to law school, study abroad, be an electrician, yet she can be denied the fundamental right of health care? Reproductive health care services are synonymous with women’s empowerment. As long as our basic right to these services are threatened, we have to speak out and fight. It is our basic right to use contraception. It is our basic right to have access to the health care services we need.