Tagged Women’s Health

Podcast: ‘What The Health?’ Meanwhile, In Other Health News…

Most followers of health policy have been consumed lately by the potential repeal or alteration of the Affordable Care Act, as well as the ongoing open enrollment for individual insurance for 2018.

But that’s far from the only health news out there. In this episode of “What the Health?” Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Alice Ollstein of Talking Points Memo, and Sarah Jane Tribble of Kaiser Health News discuss some of the important but under-covered stories you might have missed this fall, including prescription drug price fights and women’s reproductive health.

Among the takeaways from this week’s podcast:

  • Lobbyists are coming out of the woodwork – spending more than $42 million over the last quarter — on a battle over whether Medicare should reduce what it pays for drugs at hospitals that primarily serve low-income patients.
  • Massachusetts has passed its own guarantee of no-cost contraceptives for women, after the Trump administration rolled back the federal health law provision.
  • The health law’s individual mandate is front and center in the tax debate, but it’s not clear how the Senate will come down on it. Some GOP moderates are suggesting that they might support the repeal if another bill to help stabilize the individual insurance market is approved. Yet at the same time, the White House is signaling that it might be fine dropping the mandate.
  • Of course, if Congress opts not to tackle the mandate, the White House could take some actions later to neutralize the provision. That could add another log on the fire as critics seek help through the courts to stop administration actions.

Plus, for “extra credit,” the panelists recommend their favorite health stories of the week they think you should read, too.

Julie Rovner: The Washington Post and Kaiser Health News’ “Ambulance trips can leave you with surprising – and very expensive – bills,” by Melissa Bailey.

Joanne Kenen: The New York Times’ “Skin Cancers Rise, Along With Questionable Treatments,” by  Katie Hafner and Griffin Palmer.

Alice Ollstein: The Washington Post’s “What the parasites in a defector’s stomach tell us about North Korea,” by Cleve R. Wootson Jr.

Sarah Jane Tribble: The Washington Post’s “How we got the story about monkeypox,” by Lena H. Sun.

To hear all our podcasts, click here.

And subscribe to What the Health? on iTunesStitcher or Google Play.

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The Power Of #MeToo: Why Hashtag Sparks ‘Groundswell’ Of Sharing — And Healing

As a Ph.D. candidate in the social sciences more than 20 years ago, Duana Welch, 49, had done enough research to know the consequences she’d face by reporting sexual harassment in the workplace.

“When women came forward with allegations of sexual abuse and sexual harassment, the woman was the person blamed and the woman was not believed,” she said. “I was very angry that I would pay the price for coming forward. I knew what would happen.”

Like most who’ve had similar experiences, Welch, a relationship expert in Eugene, Ore., kept quiet. She wanted to bury the inappropriate encounters initiated by men who outranked her in the workplace. Welch worried that her fledgling career would be doomed.

That was until #MeToo.

“I jumped in immediately,” she said. “I knew that this was our moment. It was the first time I became very public about abuses and inappropriate sexual conduct that I’ve experienced.”

But figuring out why Welch and the millions who have posted on social media using #MeToo isn’t as simple as chalking it up to the power of the hashtag. Rather, a complex set of psychological and sociological factors is at work. Sparked by revelations about Hollywood titan Harvey Weinstein, the mushrooming list of accused harassers and those unwilling to stay silent any longer illustrate that what’s happening with this avalanche of disclosures is more than just a show of strength in numbers.

“Admissions of being a victim are stigmatizing,” said John Pryor, a professor of psychology emeritus at Illinois State University who has studied sexual harassment for more than 30 years and is participating in a National Academy of Sciences study of sexual harassment in STEM fields — science, technology, engineering and mathematics.

“Research has shown that people with stigmatizing conditions that can be hidden often engage in what is called ‘label avoidance.’ With regard to sexual harassment, the more people who come forward and say ‘me, too,’ the less stigmatizing the label,” he said.

Gayle Pitman, a professor of psychology and women’s studies at Sacramento City College in California, said the sense she’s gotten from the #MeToo posts are “almost like a catharsis.”

“‘Finally, I can release this.’ There’s also some fear. ‘What happens now that I outed myself? What are people going to think of me and how am I going to feel now?’” she said. “There is definitely a possibility of reliving a traumatic experience or dredging up past wounds. A lot of people who have been victims of sexual violence probably have untreated PTSD [post-traumatic stress disorder] and can lie dormant for a long time until something triggers it — even a deliberate disclosure.”

The risk of triggering a traumatic experience is lessened as more women step up and validate the experience. “You think less that it’s my fault and I did something wrong and you’re blaming yourself,” said Lucia Gilbert of San Jose, Calif., a professor emerita of psychology at Santa Clara University. “It validates that you have been validated. Now there’s a validation in the culture, and that’s huge.”

Social media is at the heart of this change, experts agree.

“It connects one person’s story to a much broader story and simultaneously creates heft to your story. It’s not just me. My voice is a part of this giant groundswell,” said Amanda Lenhart, of the nonpartisan think tank New America, who has studied the internet and American life at the research institute Data & Society as well as at the Pew Research Center.

Although viewed as a critic of social media, psychology professor Jean Twenge of San Diego State University — whose book “iGen: Why Today’s Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy — and Completely Unprepared for Adulthood — and What That Means for the Rest of Us” explores the detrimental effects of smartphones on youth — said the #MeToo trend illustrates the positives of social media.

“It allows people to band together and share their stories at lightning speed,” she said. “The workplace certainly ups the stakes for the person experiencing the sexual harassment, and it also ups the level of anger because you’re talking about someone’s livelihood. You’re talking about a career or feeding their kids. Part of the conversation is not just the Hollywood starlet but the cashier at the grocery store.”

Women may believe now is a safer time to disclose what they wouldn’t have before, said Gilbert.

“Women are speaking up, and the political environment feels different,” she said. The worldwide women’s march on Jan. 21 “was huge. Women may better understand the importance of fighting for their rights.”

She suggests that change is possible when power shifts to more women at the top in certain traditionally male-dominated industries, such as the entertainment and media arenas, politics, the sciences and tech.

“It’s much harder to change the pattern of behavior and the sense of entitlement when you don’t change the power differential,” Gilbert said.

In his 1995 study of more than 2,600 employees at a government agency with more than 8,000 employees in 37 offices nationwide, Pryor found that office norms and the workplace culture are underlying factors — which hasn’t really changed in the decades since.

“If you look at women in those offices, office by office, women were more likely to say they were sexually harassed in the offices where the men said it was tolerated,” Pryor said.

Family law attorney Cindi Graham, 53, of Amarillo, Texas, knows all about how such behavior can be tolerated.

“There’s a lawyer who says inappropriate statements, and everybody just laughs and says that’s who he is,” she said. “It’s offensive. He’ll blatantly stare at women’s breasts. He won’t go so far as grope, but he’ll leer.”

Welch said the inappropriate behavior and harassment she experienced ranged from having a supervisor expose himself to her in his office (which caused her to quickly transfer and take a pay cut) to being harassed over a two-year period by a man whose office was located in her path.

“He had a lot of power, including power over my career,” she said. “I found another way to get into the building and he came to my office and said, ‘It’s starting to feel like you’re avoiding me.’”

“In my early 20s, my story would have been an isolated event brushed away and me blamed for it,” Welch said. “I wanted to add to what I see is a really important cause. Now most people are believing us.”

KHN’s coverage of women’s health care issues is supported in part by The David and Lucile Packard Foundation.

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Mental Health Public Health

Sip Wine And Chat About Postponing Motherhood — At An ‘Egg Social’

BEVERLY HILLS, Calif. — Your grandma hosted Tupperware parties. Your mom attended Mary Kay soirees.

Now, you might be sipping cocktails at an egg-freezing fête.

Judging from a recent event at a swanky Beverly Hills hotel, female fertility could be the next big thing in direct marketing.

About 20 women — and a few men — gathered recently in the presidential suite of the Viceroy L’Ermitage in this famously upscale city to chat, drink wine and eat hors d’oeuvres while hearing about the possibility of freezing their eggs for future conception.

Some of the women said they hadn’t found the perfect partner and wanted to keep their fertility options open. Others said they were focused on their careers now and didn’t want to compromise their chances of having a family later.

All were willing to put aside their inhibitions for one evening to learn about an intensely private subject in an unusual setting: a cocktail party.

Frances Hagan, 35, had heard about the “egg social” from a friend and was eager to find out how egg freezing worked. Hagan, a lawyer, said she is single and still hopes to find someone with whom she can have children the old-fashioned way. But she said it doesn’t hurt to consider freezing her eggs as a backup.

“I’d like to wait and just see what happens,” Hagan said. “But if I wait too long, maybe it won’t happen. I’m trying to be proactive.”

It is probably no coincidence that the event was held in a place like Beverly Hills, given the considerable expense of freezing eggs — and of using them later.

Egg freezing costs between $10,000 and $15,000 for the procedure and the medications. Thawing the eggs and fertilizing and transferring an embryo could cost thousands more later on. A few Silicon Valley employers, including Facebook and Apple, cover egg freezing for their workers, but most employers and insurers do not.

Two Southern California Reproductive Center employees register attendees of an “egg social” at the presidential suite of the Viceroy L’Ermitage in Beverly Hills, Calif. (Anna Gorman/KHN)

Dominika Martinez, 35, who decided to freeze embryos with her husband after getting married last year, attends an “egg social.” (Anna Gorman/KHN)

In the past, egg freezing was primarily for women who risked infertility because of cancer treatments. But in recent years, more women have been choosing to freeze their eggs for non-medical reasons — such as not being ready to have a baby.

As the practice becomes more widespread, so do events designed to raise awareness of it and recruit patients for clinics that perform the procedure. In recent years, cities such as Los Angeles, New York and San Francisco have been the venues of egg-freezing parties.

At the Beverly Hills hotel, physicians from the Southern California Reproductive Center, the fertility clinic that sponsored the event, projected slides on a wall and explained the history and science of egg freezing. They told the guests that it was an insurance policy for women who want children in the future.

“It’s the smartest thing any woman can do if they are not in a serious relationship that is leading to children,” said Shahin Ghadir, a fertility specialist at the practice.

Ghadir said hosting women in a casual environment makes the idea less intimidating and stigmatizing. “It lets people know it’s not a medical issue — it’s a social issue,” he said.

Besides, Ghadir said, “with a glass of wine, everything sounds better.”

The first baby created from a frozen egg was born about 30 years ago, but it wasn’t until 2012 that the American Society for Reproductive Medicine declared that egg freezing should no longer be considered experimental. That opened the door for more women to freeze their eggs, said Evelyn Mok-Lin, medical director of the UC-San Francisco Center for Reproductive Health.

UC-San Francisco started offering “elective” egg freezing soon afterward, and the number of women opting to freeze their eggs has since risen sharply, Mok-Lin said.

More than 6,200 women in the U.S. froze their eggs in 2015, up from 475 in 2009, according to the Society for Assisted Reproductive Technology. And 155 births resulted from the fertilization of women’s frozen eggs in 2014, up from 28 in 2009.

Egg freezing gives women control over their reproductive health and fertility, and the medical risks are very low, said Mok-Lin. But given the high cost, not everyone can afford egg freezing, and it doesn’t always work. “It is a luxury for many people and without any guarantee in the end that the investment will pay off,” she said.

The process involves stimulating the ovaries, extracting the eggs and flash-freezing them.

Necka Taylor, a nurse who attended the Beverly Hills soiree, said her first cycle of in vitro fertilization was unsuccessful, but she’s hoping to try again. Taylor, 32, said she has several friends who have had babies, and she knows she wants children herself.

“I just don’t know when it’s going to happen,” she said. “I knew I needed to take steps to have a healthy baby.”

Her friend Dominika Martinez, 35, said she had considered egg freezing in the past but it wasn’t until she got married last year that she decided to freeze embryos with her husband.

“I am still not where I want to be in my career,” said Martinez, a social media marketer. “I feel like I need a little more time.”

Martinez said that when she and her husband are ready, they will try to conceive naturally. But if it doesn’t work, she said, “we have a backup plan.”

Ghadir, of the Southern California Reproductive Center, told the group that he had children and had not anticipated the expense, time and energy of parenting. Freezing eggs can help women have children on their own timeline, he said.

“If I was doing this at the wrong time in my life, it would have been a disaster,” he said. “Doing things at the right time, when you know you are ready … is one of the most important reasons to freeze your eggs.”

KHN’s coverage in California is funded in part by Blue Shield of California Foundation. Coverage of women’s health care issues is supported in part by The David and Lucile Packard Foundation.

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