succumbing to peer pressure

Saturday, February 25, 2006

Just finished Supersize Me. Just want to say:

Mom - Thanks for packing my lunch, practically everyday, literally, until I left for college.
Mom and Dad - Thanks for making so many home cooked meals, for keeping a fridge full of real food, and for limiting me to one soda per day.


My afternoon as a liberal at the Annual Convention of the Georgia Association of College Republicans

First, why I attended this convention - I think about all the misconceptions I've heard about liberals and Democrats and what they stand for and what they believe and realize what a hypocrite I would be if I did not at least attempt a better understanding of what conservatives and Republicans honestly believe and stand for. I want to believe that it's possible that we (or at least, a majority of us) can find common ground with regard to the problems and challenges facing our country, and that debate about philosophical differences regarding the best solutions to those problems is possible. I know. Call me crazy.

The first two speakers were Ralph Reed and Casey Cagle, both candidates for Lieutenant Governor of GA. This started out generally ok. Both talked about their desire to make life better for Georgians and said nice, passionate things about how they didn't have to be state senators or representatives or Lt. Governor, but they wanted to be because they believed they could make a difference. That's a nice starting place, in my opinion. They said standard sorts of conservative policy things, about tax cuts and helping businesses create jobs and whatnot. I disagree with most of these things in general, but whatever, it takes all kinds, and this is fine. Reed veered off a bit into language I personally find a little scary, talking about how government is 'ordained to protect God given liberties.' He also claimed that unknown numbers of marriages and lives were saved because he opposed expansion of casino gambling, and prevented from opening or closed 8 illegal casinos. Well, government saving my marriage and my life...that sounds kind of a lot like the invasive, big government Republicans seem to dislike, doesn't it?

Cagle also referenced God, saying he prayed about the decision to run for Lt. Governor. Again, religious language in politics creeps me out, but it's their thing, if they want to wear it on their sleeve that's their right (as long as that sleeve doesn't drip into state policies, which unfortunately in GA, it inevitably does). Cagle said some seemingly reasonable things about reducing the government bureaucracy that ties public teachers' hands and makes it difficult if not impossible to structure their curriculum around what works best for individual children. Then he praised the No Child Left Behind Act, which is essentially the definition of government bureaucracy.

And underneath it all there was this subtle, endemic sort of sexism. All the visible leaders within the College Republicans were white men, the people in attendance were heavily skewed both white and male, the majority of women there wore skirts and the one who introduced a speaker was meek and barely audible, in contrast to the three men who preceded her in the program who didn't need the microphone and moved casually and comfortably around the stage. All politicians and candidates were referred to blanketly as male - we want the best man for the job! We've always elected a strong guy! GA will vote for the guy they can trust! Cagle referred to his opponent in an earlier race as "attractive" and the "wife of a physician." Nothing else. Not a single detail about her as a person or politician. Speakers consistently referred to the liberal media and radical feminists.

Ok, so I was looking for it. I tried, but it was obviously impossible to sit there with an open, non-judgemental mind. But the few people I spoke to were nice, and up until this point, things seemed fairly reasonable. Except that everyone kept giving accolades to Phyllis Schlafly. Saying how she was one of the most important historical figures in the conservative movement and what a hero and inspiration and role model she was. As soon as she started speaking I kept looking to the woman sitting next to me for some indication that this was a little extreme, a little overboard, a little different from the beliefs held by everyone else in the room. Silly, naive me. Schlafly spoke about how Communists infiltrated the US Government during the Roosevelt and Truman administrations. She said that Johnson was the worst president ever because he changed the character of many American people by allowing government handouts like welfare and food stamps, creating a citizenry with a sense of entitlement, with the idea that government should solve all their problems. She correctly noted that had the Equal Rights Amendment passed it probably would have been used to make gay marriages legal. Then she started things that are factually inaccurate. She said the ERA would have taken away rights women already have, and that the Constitution is a 'sex neutral' document and that women have had all of the exact same Constitutional rights as men from the first day it was adopted. Well, she's sort of right. The Constitution is sex neutral - it refers to People and Representatives, even the part where it says, "...which shall be determined by adding to the whole Number of free Persons, including thsoe bound to Service for a Term of Years, and excluding Indians not taxed, three fifths of all other Persons." We know other Persons meant black people. We know women weren't even considered people. And if women really had all the same rights as men from the moment the Consistution was adopted, why did we need the 19th Amendment and why weren't we allowed to vote until 133 years after the Constitution was adopted? She said the ERA would mean that women would be eligible for the draft, and well, that's true too, but equality means equality damnit, and why should men be singled out for such a burden? She complained that one of the planks for the women's movement was the idea of state-funded child care "so women wouldn't have to endure the oppression of raising their own children." This got a chuckle from the whole room. But wait, earlier Cagle mentioned that he was raised by a single mom who worked two jobs? Isn't it possible that she might have liked some state-funded child care? Shlafly railed about not trusted judges to rule on issues like the pledge of allegiance, the definition of marriage, the ten commandments, and the boy scouts. Wow, what a set of priorities she has. She implied, hell, stated, that Harriet Myers was a product of affirmative action. On and on and on. And still I'm hoping that this isn't really jiving with the audience. And then a young woman raises her hand during the question and answer period. Mrs. Schlafly, you've been such a supporter of the conservative movement, but also a good wife and mother. How do you manage to balance your life? I could have cried.

There's tons more, but I have to stop. I think I need a shower.

Friday, February 24, 2006

What I learned Today

Former Women's Health Chief at the FDA Susan F. Wood gave a seminar this morning about emergency contraception (EC). She resigned last year over the approval process for an over the counter (OTC) version of EC.

First, a little FDA 101. The FDA has jurisdiction over about 25 cents of every consumer $1, covering things like prescription and OTC drugs but also product labeling, medical products, and policies related to clinical trials. It does not, however, regulate the practice of pharmacy or medicine - i.e. the FDA approves a drug, but the medical profession determines how to prescribe it and the medical and pharmacist associations determine who is an approved prescriber and things like that (this becomes important later in our story). Companies seeking FDA approval for a prescription drug must show that it is safe and effective, typically through data from clinical trials. Companies seeking OTC approval have to answer three questions - 1) do you need a doctor (or other professional) to diagnose the problem? 2) do you need a doctor (or other professional) to determine the appropriate treatment/action? 3) can you determine how to use the product using only the label? These questions are answered using data from label comprehension and actual use studies.

Now, a little EC 101 - Emergency Contraception is exactly the same as other forms of contraception in that it works along the same physiological mechanisms. EC primarily prevents the fertilization of an egg, and although there is no scientific proof of this ever happening, it is possible that it changes the condition of the uterus to make it less likely that a fertilized egg will successfully implant. This is exactly what an IUD is specifically designed to do. So, again, EC does the same thing as other already available forms of contraception. And it is not, in any possible way, an abortifactant.

Now, on to the approval process for EC. Within the FDA organizational structure there is an advisory committee set up for each drug submitted for approval. This committee makes recommendations, and it is not terribly uncommon for groups or individuals higher up in the organizational structure to overrule these recommendations. It is, however, incredibly uncommon for the decisions and suggestions from every single level of scientific review to be overruled, which is exactly what happened in the case of EC.

In December '03 the advisory committee voted 23-4 in favor of OTC status for EC and voted unanimously that it was a safe drug. This is important to note, because at no point in the approval process was EC ever considered unsafe. From here the application moved up the typical channels within FDA to the level at which agreement would normally result in issuing an official decision.

Instead, in May '04 the application went to the Center Director, who said it was 'non-approvable' (which essentially means there are significant problems that must be resolved) and requested a two-tiered prescription/non-prescription status for EC (making it available OTC for 'older' teens and adults, which means anyone 17 and older and requiring a prescription for younger teens). This was the first mention of the idea that availability of EC OTC might cause an increase in risky sexual behavior among teens. Data exists that shows the only behavior change resulting from increased availability of EC is an increased likelihood that a woman will use EC after a failed primary contraceptive event (which, you know, is sort of the whole damn point of EC). Nevertheless, FDA requested additional data be collected on young teens (which may or may not be a reasonable request, but it is the first and only time FDA requested any additional data on any subpopulation when the available data was considered to be representative of the population for whom the drug/treatment was intended).

Now, in Wood's words, the Center Director is not a bad guy, and he genuinely believed that by compromising with the 2-tiered program they would be able to get approval for EC OTC, at least for women 17 and over, which would be a step in the right direction.

So the company collected more data, and resubmitted the application during the summer of '04. By the winter of '05 it was generally known within FDA that EC would be approved for OTC status. Then, as Wood describes it, silence settled in. She says that everyone she spoke to said they recommended approval months ago and no one had any idea what the hold up was. Every single person Wood knew within the professional approval chain was out of the loop. By summer of '05 there was still no decision, so Congress stepped in and held up hearings on a new FDA director until they agreed to take some 'action' on the EC issue by September.

In August '05 the FDA commissionor says they are ready to approve EC for those 17 and up but that the 2-tiered program is complicated and needs to be opened up for public comment and rule making to determine how to establish regulations. This is, conceivably, a reasonable suggestion. But, as Wood points out, it works out to the same thing as failing to approve EC and is essentially a stall tactic that could take years or last indefinitely. Furthermore, there are already many regulations in place for similar 2-tiered prescription/OTC drugs. For example, low dose ibuprofen is available OTC, but high dose requires a prescription. The nicotine patch is available OTC for those 18 and over, but requires a prescription for younger teens. There is a system in place for these problems/complications. And lastly, these sort of regulations are for the medical and pharmacist associations to work out, it is technically not under the jurisdiction of the FDA to determine how and to whom to make drugs available.

At this point Wood again reminded us that there is NO safety issue here. It is not possible to overdose on EC (unlike several other readily available OTC drugs). Lastly, according to the FDA 'decision making for health policy must be based on scientific and medical evidence [and] must promote health." Wood concluded that this decision did neither, and she resigned in protest.

The bottom line, according to Wood, is that this is an indication that the FDA leadership is NOT independent, which essentially means that the FDA is unable to do it's job, which is to make decisions regarding public health and safety based on scientific evidence.

Once the floor was opened up for questions/comments the dean of our school, Jim Curran, mentioned that politics have long had a negative relationship with the environment and sex (he should know, he was a CDC division director when HIV/AIDS first appeared) and then went on to rail about "these assholes in Congress" and the codification of homophobia in the military (can you imagine losing your job because you stood up and said I'm back? Or I'm female? It's outrageous!). Made me proud that he's our dean, and was a happy reminder that all those people who used to pat me on the head and say I'd outgrow all my righteous indignation were wrong.

So it was a good way to start out my Friday, and hopefully will be a bit of an innoculation against whatever I'm about to expose myself to at the repub convention tomorrow.

Thursday, February 23, 2006

My New Best Friend

Went out for beers last night, which turned into wine back at his place, which resulted in him oversleeping for a meeting at work and me making the best phone call to Corrine - Can you come pick me up? I'm not sure where I am. Ah, the student life!

Wednesday, February 22, 2006

Gulp. I just registered for the Georgia Association of College Republican's Annual Convention. It's being held on Emory's campus, so it's conveniently located, and free. Speakers include Casey Cagle, Ralph Reed, and Phyllis Schlafly. It's hard to pass up an opportunity to see Schlafly in person, and I'm honestly curious what the rhetoric sounds like when repubs are addressing themselves...anyone want to come with and help me keep my mouth shut?

Tuesday, February 21, 2006

And so it begins

The Supreme Court has agreed to hear Gonzales v. Carhart, which will determine the constitutionality of the "Partial Birth Abortion Act of 2003." (again, there is no such medical procedure as a partial birth abortion. it's a dilation and extraction, damn it) Last time they heard a similar case the law was struck down 5-4. You guessed it, O'Connor was the deciding vote. As it stands, the Act does not allow for any exceptions taking into consideration the health of the woman. Of course not. We aren't human, we're just baby making machines.

Monday, February 20, 2006

Just a reminder:

The official poverty line, from almost any viewpoint, represents a meager life at best. Currently a family of four including two adults and two children is declared poor with an annual income of $19,157 or less, regardless of location.

And that's still more than someone working for minimum wage makes. Before taxes.