Reproductive Health and Teenage Pregnancy: Tips for Providers

Curious about updates to standards around contraception, reproductive health and teenage pregnancy care, and safer sex for adolescents? Here are my livetweeted notes + some slides from a webinar overviewing key evidence-based practices which streamline reproductive health and teenage pregnancy services for adolescents. The webinar also gave data on what teens need and what kind of behaviors they’re engaging in. Though aimed at medical providers, I think the session produced nuggets of information for all kinds of folks!

The Time is Now:
Adolescent Friendly Reproductive Health Care Webinar

Speakers:

Erica Gibson, M.D., & Judy Lipshutz, MSW, RN, NYPATH
Heilbrunn Dept. of Population & Family Health, Columbia University

Topics that were covered include:

Quick Start Contraceptive Initiation
Emergency Contraception
Pregnancy Testing
Long-Acting Reversible Contraceptives (LARCS)
Expedited Partner Therapy (EPT)
STI Treatment

Did you know?

  • In 2013, the Youth Risk Behavior Survey said that over 60% of HS students reported using a condom at their last sexual encounter.
  • The average sexually active teen waits 14 months before seeking reproductive/sexual health services, and the catalyst is usually the desire for a pregnancy test.
  • The types of emergency contraception  in the U.S. include Levonorgestrel pills (e.g. Plan B), the copper IUD (e.g. ParaGard), & ulipristal acetate pills (e.g. ella).
  • In July 2014, the The European Medicines Association issued the following statement: “emergency contraceptives can continue to be used to prevent unintended pregnancy in women of any weight or body mass index (BMI). The available data are limited and not robust enough to support with certainty the conclusion of decreased contraceptive effect with increased body weight /BMI.”

 

Transgender Hate Crimes Monitoring Bill- S2488 becomes law

Announcement from Youth Pride Inc.:
Last week, Governor Chafee signed the Transgender Hate Crimes Monitoring Bill into law.
Youth Pride Inc. wants to thank the General Assembly and the Governor for their support of this legislation. 
Rhode Island law will now contain the words “gender identity or expression” in the definition of a bias motivated crime for monitoring purposes. It will require that statistics on crimes motivated by gender identity/expression related bias to be kept by the State Police along with other bias motivated crimes. It will also include gender identity or expression in “mandatory training standards to provide instruction for police officers in identifying, responding to and reporting all incidents of ‘hate crimes’,” in accordance with RI General Law 42-28.2-8.1.  
In 2001, Rhode Island became the second state in the country to add “gender identity and expression” into its non-discrimination laws, there are now 16 states plus Washington DC with such laws. Today, we celebrate as Rhode Island becomes the 16th state plus Washington DC to recognize crimes motivated by prejudice and bias due to “gender identity or expression.” 
Youth Pride wishes to thank bill sponsors  Sen. Perry, Nesselbush, Miller, DeVall, and Crowley, as well as Reps. Ajello, Handy, Blazejewski, Cimini, Walsh and Ferri for their support in this effort. Youth Pride also wishes to thank our community partners in this effort including the RI Commission on Prejudice and Bias, Marriage Equality Rhode Island, Gay & Lesbian Advocates and Defenders, TGI-Network, the RI Chapter of the ACLU, RINASW as well as Rhode Island’s Transgender community and their allies.  
Jayeson Watts, MSW, MT-BC
Direct Services Coordinator                                                           
Youth Pride Inc.
743 Westminster St.
Providence, RI 02903
Connect with Youth Pride Inc. on Facebook and find out what is happening this week at YPI!

Testimony Around Reproductive Health and Abortion Bills in RI

On Wednesday, I went to the RI Statehouse to testify because there was a hearing for a group of bills around reproductive health. I’d gone last year and found it important to go once again and have my voice heard. Being part of the political process in a room with passionate people (even if they’re not all in my camp) is invigorating and bizarre, especially stuck up in a balcony…but anyway. More on my feelings, thoughts, and observations about the process later. I wanted to capture my testimony (which I wrote as I waited to speak) and share it with y’all.
(BEFORE PROCEEDING: Look at the bills and their text! Check them out here.)
The following is my testimony:
My name is Aida Manduley and I’m here in support of bills 7754 and 7041, and in opposition to the rest of the ones on the docket.

Before I discuss my support of those 2 bills, I want to address what previous speakers have mentioned around intent <Note: For context, this was directed at the legislator who proposed the bill around mandatory ultrasounds and “informed consent.” She kept talking about her intent this and her intent that, how we were “misinterpreting” her intent and blah blah blah>. In making major political decisions, we need to look at context, intent, AND effect…and ultimately, effect trumps intent. Even “well-meaning” legislation can have unintended effects, and THESE effects are what can create barriers to care, misinformation, and unnecessary political interference with personal, medical decisions.

As someone who works at a domestic violence agency, as someone trained in dealing with sexual assault and crisis assistance, as a sexuality educator, and as a woman, I have personal as well as professional experience in what these bills would mean to women across Rhode Island.

In regards to bill 7754, this is a bill to keep our youth SAFE. This isn’t a bill to take parents out of the equation, but to give pregnant teens bodily autonomy–to give them the option to, through contact with trained professionals and authorities, make personal decisions about their future and care. 

In my work, I educate, and encourage parent-child conversations around these issues, but must admit that these conversations are NOT always possible, and not always safe. I’ve encountered minors who are NOT supported by their families, who regardless of their own wishes, would be forced to carry an unwanted pregnancy to term if this bill did not pass. I’ve encountered young women abused by their own families (emotionally, physically, and sexually), for whom it is not safe to require parental consent for an abortion, for whom it is even re-traumatizing to event attempt to do so.

I’ve served and counseled young women, scared and pregnant, some already with children, who are in abusive relationships where condom negotiation isn’t possible, whose families don’t know about their relationships or who are even buddy-buddy with the abusers–women who are already experiencing health disparities and barriers to care…am I supposed to tell them I must repeat the patterns of their abusers? Am I supposed to tell them our legislators have decided that they ultimately have NO choice about what happens to their bodies? Please consider what I have said, as someone who has both personal and professional experience with these issues, and support bills 7754 and 7041.

Young and Silly

Let’s lighten up the mood of this blog!
What better way to do that than by posting ridiculous pictures of myself when I was a kid?

Yes, folks, there WAS a time when I didn’t have boobs.

With my mom.
OH THE GRAND FINALE. OH YEAH. 
I WAS SUCH A COOL KID.
The end.

KinkForAll Providence: Clarified [Updated]

While I was planning KinkForAll Providence, I was contacted by Brown officials because a community member was emailing the University with concerns about the event. Though, as I found out, most of these concerns were alarmist and visibly laced with prejudice and ignorance about the event and many of the sexuality topics that we hoped to address, the University heard this individual out and I met with various Brown officials to discuss the points that had been raised. After speaking with me and making sure I was following the appropriate protocol (which I was already doing because I’m a very experienced event organizer at this institution), the Brown officials did not find a reason to cancel the event or do much else, other than closely review my plans and tell me to keep in communication with them before, during, and after the event.

That, however, was not the end of the saga. After KinkForAll was held on February 6th, and after Get Your Heart On: Sex Educator Showdown with Reid Mihalko (a Brown alum) and Megan Andelloux (a certified sex educator) happened on Valentine’s Day (co-sponsored by SHEEC, Feminist Majority Leadership Alliance, Students for Choice, Queer Alliance, Sarah Doyle Women’s Center, and Brown Health Education), the emailing continued.

As I eventually found out, thanks to the Internet, this community member was someone by the name of Margaret (Barber) Brooks, none other than a Brown alum and professor of Economics at Bridgewater State College in MA. I was deeply saddened that a professor and Brown alum would go to the lengths she did to shut down a student event (or two, really), especially one aimed at creating a space where information about sexuality could be shared, a space where people could feel safe and empowered to discuss these issues without being judged. I appreciated her concerns and her desire to maintain Brown students and community members safe, but the overall manner in which she approached the situation was appalling. 

Aside from the emails, she and Donna M. Hughes, a URI professor, posted and widely circulated a bulletin about the event. The bulletin, however, was more about bad-mouthing my friend Maymay (the co-founder of the KinkForAll unconference model), spreading inaccurate information about KinkForAll Providence, and fear-mongering than actually addressing any real issues.

Did Margaret ever reach out to me, the event organizer? No.


Instead, she chose to contact Brown multiple times, even after the University officials responded with their final decision to allow SHEEC to make the events happen.

Did Donna ever reach out to me? I’ll give you one guess.

Neither of these individuals have engaged with anyone directly related to the events’ organization. Instead, they have paid eerily close attention to our blogs, Twitter accounts, Google-groups, and online presences and have then twisted the information found there to fit their agendas. They have spread inaccurate information (heck, they have spread flat out LIES) and incited other individuals to call us horrible things, such as sex-traffickers.

Because of this, and because I believe in what I do (and I want to be as transparent as possible), I wish to clarify certain things about KFA Providence. Though most (if not all) the information in this post is easily available on the Internet, I will attempt to make a concise summary of concerns and my responses/clarifications.



1. KinkforAll–model or organization?


KinkForAll is a conference model, not an organization. Simple as that. There are no “members” or general KFA “presidents.” Each KFA event is specific to that time, place, and set of organizers. As far as KinkForAll Providence goes, I can’t claim ownership of the MODEL, but I can claim responsibility for the drive and organization of that event.
2. KFA’s relation to Brown and who organized it

I was the main organizer, and my community co-organizer was Emma Gross. The sponsoring group was SHEEC. It’s insulting to hear people like Margaret (Barber) Brooks and Donna M. Hughes credit Maymay with organizing the event, because that was not the case. Personally, while I think May is an AMAZING human being (a-may-zing? wow, I just went there) and I appreciate his founding the KFA model, I feel my work is being invalidated and dismissed by these two women. Furthermore, I feel that one of the organizations I lead at Brown University, the one dearest to my heart, is being disparaged. This is all very unacceptable.

The idea that “No one is apparently in charge; therefore no one is responsible” is, again, insulting, because I was clearly in charge and SHEEC was the group responsible. If anything had gone wrong, it would have been our responsibility. 

Throughout the conference, we stated that the sponsor for the event was SHEEC, and that Brown was giving us access to the venue through that. This was said a few times, and in multiple rooms, and also during the live-stream. I also know that in CarnalNation, the language used was “held AT Brown,” which is accurate. Also, there were signs in the building explaining what the content was, where the livestream was, that the sponsor was SHEEC, and so on. Everything was carefully labeled.

In regards to us using Brown’s Wi-Fi and facilities, and arguments that these conditions make Brown a sponsor? By that logic, it would mean that ANY and EVERY event held on campus is “officially sponsored” by Brown University. This makes no sense, and is NOT aligned with Brown’s definition of sponsorship. In our communications, we weren’t using Brown’s name to make it sound “more legitimate” or anything; we merely had to use Brown’s name so that people would know where the conference was being HELD. Finally, GuestIDs are given to people who stay at the Brown Inn and people coming in for conferences, so this, again, was within their/our right to pursue.

3. Safety issues and children

This particular event would have never resulted in children being “approached, propositioned, or molested.” We took specific safety precautions to ensure the comfort of all our participants and to make sure that everything going on at the event was legal, consensual, safe, and in accordance to Brown’s policies and regulations, as evidenced by my meetings with Brown officials and the ridiculous amounts of signs and posters stating what was going on and what rules the attendees and presenters had to abide by. Furthermore, no minors were allowed at the conference unless they were there with a legal guardian or parent.
4. Extra rooms and “one Brown female undergraduate at the conference” that “appears to have engaged in a sexual activity at approximately 2:20 pm” 

Extra rooms, yes. I reserved them to make sure that all the people on the first floor were people we WANTED there, and who were explicitly coming for the conference instead of merely wandering in. We also had greeters at the door, time-keepers in the rooms, and people flowing in and out of presentations making sure things were going according to plan. In regards to small groups of participants going off by themselves into the extra rooms—I wandered around and people were always in rooms where presentations were actively going on; otherwise, the other rooms were empty. The only time when presentations were NOT going on was during lunch, from 1 to 2 pm, and we were on break. 

A Brown undergrad “engaging in sexual activity” at approximately 2:20…? What does that even mean?

There were NO SEXUAL ACTIVITIES TAKING PLACE AT OUR EVENT (unless you count DISCUSSIONS about sexuality) and we made it clear at the beginning of the event and on the venue rules in each room that no sex/nudity/play was allowed. 
5. Credentials of presenters
The public is welcome, and thus, we don’t require people’s credentials in, say, sexology or psychiatry when they want to present about a topic they’re passionate about. This conference is a place for people to speak candidly about sexuality from their own perspectives, and that is how we describe it. We do not in any way misrepresent who is attending and what they’ll be doing at KinkForAll.

6. Videos and livestream 
All the people who were videotaped either personally asked us to record them OR specifically chose to use Room 102, with the livestream. NO ONE was taped that did not consent to being taped; we had our sticker system (orange dot = do not tape), time-keepers, and organizers helping enforce this in every room. We made everyone who was going to take pictures be identifiable on their name-tag, and the people taking pictures were basically me and Meitar. There was a huge sign explicitly stating that there was a live-stream in room 102 and what that meant (for those people who were unfamiliar with the term “livestream”). Furthermore, there were signs ON the computer that was recording and all around it cautioning people that it was taping, so no one would accidentally walk into its line of vision (another reason why we angled it in such a way that it wouldn’t capture the doorway).
7. Meitar, KinkForAll, KinkOnTap podcast, and money

Meitar is the co-founder of the KinkForAll conference/model. He has organized some KFAs, but not all of them. Re: KinkOnTap podcast, Megan Andelloux and I were on as guests the day after KFAPVD, and a) this podcast is NOT personally making Meitar money at all because whatever donations they receive are for the funding of the program itself and b) the podcast is a separate entity that is not seeking to make money off KFA Providence. The podcast is separate and, yes, we mentioned KFAPVD, but that’s because we were talking about recent events and news items (such as the Don’t Ask, Don’t Tell policy articles that have been floating around). The footage shot at KFAPVD is NOT being sold and is NOT being used commercially at all. In fact, quite the opposite. The mission statement of the KFA model is to make all this information FREELY available to everyone. That’s also the reason why the conference ITSELF is free; it’s one of the most important parts of the model! 

8. “Illegal sadist practices,” NELA’s Fetish Flea Market, and KFAPVD
As far as I know, discussing “illegal practices” is not illegal itself, or else no one could ever talk about, say, underage drinking. This conference is a place for critical analysis and discussion, where these topics can and SHOULD be addressed, especially when it comes to talking about their legal ramifications. Again, I invoke our right to free speech. As far as NELA goes, yeah, I HOPED to get BDSM advocates from across the country. The presenters at the Fetish Flea are highly respected in the community and have a lot of things to say, so they would’ve been more than welcome at our event. Also, for those of you who don’t know, NELA is  “an incorporated non-profit 501(c)3 organization dedicated to the support, education, and political organizing of the leather/fetish/SM/bondage communities in New England.”

Advocates for Youth: Criminal Miscarriage (repost)

New Utah law defines miscarriage as “criminal homicide”
Utah is poised to become the first state in the U.S. to criminalize miscarriage and punish women for having or seeking an illegal abortion. Utah’s “Criminal Miscarriage” law:
  • expands the definition of illegal abortion to include some miscarriages
  • removes immunity protections for women who have or seek illegal abortions
This law doesn’t punish individuals who perform illegal procedures; it punishes women. As someone who grew up in Salt Lake City, it takes a lot for Utah to surprise me anymore. This time there aren’t even words for my outrage.
Advocates for Youth has been working with activists in Salt Lake City to see how we can help. Their request was simple: Tell everyone you know about this law.

So far, the national media has been silent on this issue. If each of us does these three simple things, we can break that silence.
Will you take 60 seconds to spread the word?
STEP ONE

Send this link to three people right now: http://bit.ly/CriminalMiscarriage

STEP TWO

If you’re on Facebook, click here to post this story to your profile.

STEP THREE

Simply click here to share this story on Twitter.

Activists in Utah asked for our help. Let’s make sure we deliver.


Sincerely,
Will Neville Associate Director, E-Campaign Strategies
Advocates for Youth


P.S. For more background about why Utah’s “Criminal Miscarriage” law is so dangerous for women and girls, click here.

Gay Marriage Confuses Kids!

“Now they’re saying that we can’t have gay marriage because it would confuse the kids. But you know what else confuses kids? Everything: Time zones. Books without pictures. Cargo pants. Certain hair colors. Jello molds. The magic trick with the quarter behind the ear. Mirrors. Mentadent toothpaste dispensers. Everything confuses kids, because they’re kids. So “Will it confuse kids?” is probably not the best litmus test for, well, anything besides toys and Spongebob plotlines (and even then, there’s a lot of leeway). ”

This Is Your Kid On Gay Marriage | TV | A.V. Club

When ECON-speak fails, try Pokemon analogies

If you don’t know what the hell is going on with the economy and only know that it’s kinda majorly fucked, read on. (This article is resposted from HERE)

——

Economist Kevin Nguyen explains the country’s economic woes to his younger sister, using Pokémon as an analogy. Seriously.

The following is an actual conversation I had with my younger sister, Olivia. She likes to draw, play World of Warcraft, and now, she’s the only fourteen-year-old girl who understands the U.S. economic crisis.

Kevin: Have you been following the news?

Olivia: Yeah, I don’t really get it.

Kevin: Imagine that I let you borrow $50, but in exchange for my generosity, you promise to pay me back the $50 with an extra $10 in interest. To make sure you pay me back, I take your Charizard Pokémon card as collateral.

Olivia: Kevin, I don’t play Pokémon anymore.

Kevin: I’m getting to that. Let’s say that the Charizard is worth $50, so in case you decide to not return my money, at least I’ll have something that’s worth what I loaned out.

Olivia: Okay.

Kevin: But one day, people realize that Pokémon is stupid and everyone decides that the cards are overvalued. That’s right—everybody turned twelve on the same day! Now your Charizard is only worth, say, $25.

Olivia: Uh-huh.

Kevin: At the same time, you’re having trouble paying back the $60 you owe me. So what would you rather do: try and pay me back the $60 or just default and give me your $25 Charizard?

Olivia: I’d give you the Charizard.

Kevin: Exactly. Who wouldn’t? Now, the bank—I mean me—has lost $25 when I expected to make $10. What’s the lesson here?

Olivia: Pokémon is dumb.

Kevin: True, but keep going.

Olivia: That Pokémon cards might be worth less later than they are now?

Kevin: Close. You just can’t rely on them appreciating in value forever. There’s one other good lesson in this analogy.

Olivia: That you shouldn’t lend me money?

Kevin: A-ha, exactly right! You’re fourteen and have no source of income. What would convince me to lend you money if I’m not sure you can pay it back?

Olivia: Because you could’ve taken my $50 Charizard. So you could have either made $10 or gotten something worth what you gave me. If people didn’t realize Pokémon was dumb, then there was no way for you to lose anything.

Kevin: Now, instead of a loan of $50, imagine that it’s hundreds of thousands of dollars; then instead of a Pokémon card, it’s your house. The U.S.’s prosperity was built on the idea that real estate/Pokémon would never go down. Multiply this wishful thinking by thousands of people in America and you can see the scale of our problem.

Since you couldn’t pay me back, I can’t pay my bills and I can’t loan out any more money. Our country is dependent on the ability to borrow money.

Olivia: That doesn’t make any sense. If I borrow money from you, I’m going to spend it.

Kevin: Well, the idea is that you’ll spend it in a way that will make you more money in the future—like college or starting a business.

Olivia: Oh, okay. I have a question for you: did you use the Pokémon example because you think I’m a nerd?

Kevin: I just wanted to make it easy for you to understand.

Olivia: Fine. But stop telling people I play World of Warcraft. I’m totally over that.

Kevin: Don’t worry, Olivia. I used to be into way nerdier things. Have you heard of Magic: The Gathering?

Olivia: What the hell is that?

———–

A friend of mine said this was only half the picture, so I told him to take a crack at explaining it using the same analogy. This is what he came up with:

After loaning the $50 to his little sister and taking the Pokemon card as collateral, Kevin makes ten similar $50 loans to his sister’s friends, who each give him another Pokemon card as collateral. So, now he’s got $600 owed to him by ten different people, and an expected profit of $100. Kevin would like to make more Pokemon Read Moreloans, but he doesn’t have the cash available to do it.

Kevin’s solution is to go to Lyndsey. Lyndsey offers to buy Kevin’s right to collect the Pokemon loans from him for $550 — so that Kevin reduces his profit from $100 to $50, but now has the cash in hand to make more Pokemon loans. Lyndsey is betting that because Kevin has exercised good judgment as a lender and the Pokemon cards are expected to hold their value, she is pretty much assured of a $50 profit…

Meanwhile, Kevin continues to make Pokemon loans, and Lyndsey continues to buy up those loans from him in ten-loan packages. Now that he doesn’t have to bear the risk of the borrowers failing to pay him back, however, Kevin starts giving Pokemon loans to ANYONE. Random 12-year olds walk in off the street and ask him for loans, he hands out Read Morethe money, and then quickly turns around to sell the loans to Lyndsey.

Meanwhile, Lyndsey’s loan-buying strategy becomes popular. All of her friends start buying up Pokemon loans as well.

By the time that Lyndsey realizes that these borrowers are far riskier than she’d thought, Pokemons have been devalued. She is forced to shut down her loan securitization business, files for bankruptcy, and defaults on all of her debts to various other friends. But all of those other friends have made the same risky decisions, though, this causes a domino effect of ever-worsening unpaid debts within her entire social circle.

We want to celebrate that with you…unless you’re gay


Link to video of Maggie G. speaking @ the Aldrich Mansion (for NOM Family and Marriage Day Celebration in RI).

Dear Maggie,

You should look into the history of marriage before you speak.

Love, Aida

Anyhoo. The sad thing is that the beginning of this speech is pretty cute. Yeah, “we want to celebrate your loving union with you.” Unless you’re a same-sex couple, that is. Get your cooties off me!

Oh, and a little gem from the speech: as she was speaking about how marriage happens in basically every culture and blah blah blah, and it’s the union of one man and one woman, she goes “or at LEAST one man and one woman because *dismissive hand gesture* we know a bunch of small tribes believe in polygamy.”

Yikes.

Sex-Ed

Because being a minor doesn’t mean sex isn’t on the brain. 🙂

In fact, it probably means it’s on the brain MORE…and that’s why we need positive, accurate information regarding sexual health, not to mention an eradication of abstinence-only programs that don’t provide the appropriate tools for teens to make their own choices about sex and their bodies. Omitting information and knowingly neglecting to address certain issues and questions is reprehensible!

So here are some resources for the under-18 crowd (or anyone in need of some sweet sex-ed?), courtesy of Violet Blue. 🙂

————–

Don’t believe the hype! Get real sex info on these bad-azz sites.

Just because you’re under 18 doesn’t mean you shouldn’t know the truth about sex, and what other people are asking about it. Plus, a lot of things you hear in school are sex myths and could get you in trouble, so you really need to know what’s up (down there). These sites will tell you all about sex and staying safe, while staying cool with your friends and yourself. Also, if you’re not sure about how you feel about sex, if you might think you’re not like everyone else, or think you know a gay or transgender person (or like WTF gay sex is!?), these sites will tell you what’s up.

They can even help parents get a clue about something you need to tell them, or want to ask about.

Teenwire

Lots of good information about teen sexuality and how to have healthy relationships. Some portions en español. Sponsored by Planned Parenthood.

San Francisco Sex Information

Free and anonymous way to have sex questions answered.

Sex, Etc.

Created by teens for teens. Great info about pregnancy and infection prevention.

Go Ask Alice

Answers tons of questions about almost any sex or relationship related question. Columbia University Health Education Program.

Coalition for Positive Sexuality

Boring name but great info, like why sex feels good, not just STDs and pregnancy prevention. Also en español.

TeenGrowth

General teen health site with medical advisory board. Lots of information.

Advocates for Youth

Do something about how lame sex ed is in school! They have great resources; also en español.

Scarleteen

Excellent sex-positive, realistic info about pleasure and sexuality. Made for all genders but particularly girl-friendly.

Not-2-Late

information about the emergency contraceptive and where/how to get it. Also en español and en français and Arabic.

OutProud

OMG: the National Coalition for Gay, Lesbian, Bisexual and Transgender Youth offers *tons* of info and resources.

The Midwest Teen Sex Show

Super funny video show about everything from older boyfriends to backdoor sex: great teen sex topics (but not how-to’s) and your parents ahould watch it too.

Violet Blue ® 2009. Accept no imitations. Tiny Nibbles copyright 2001-2009.