The Imaginarium of Doctor Delgado: The Make-Believe Medicine Behind SB 1318

pillDr. George Delgado, a gynecologist based in San Diego, is probably not likely to win the Nobel Prize in Medicine any time soon — or ever. Delgado’s dubious medical claims have been one of the driving forces behind a piece of legislation, Arizona Senate Bill 1318, that pushes what physician and state Rep. Randall Friese calls “fringe medicine.”

Delgado runs a website called Abortion Pill Reversal, offering 24-hour medical advice to women who have taken the abortion drug mifepristone and regret their decision. “There is an effective process for reversing the abortion pill, called ABORTION PILL REVERSAL, so call today!” the website cheers. Most people have probably never heard that a medication abortion — that is, an abortion performed by administering two pills — can be reversed. If this medical breakthrough sounds new, it’s because it doesn’t exist — at least not within any kind of evidence-based, established medical practice.

So-called abortion reversal is untested for safety or effectiveness.

Unsafe abortions have always been the consequence of the anti-abortion movement. Now unsafe abortion reversals can likely be added to that, thanks to the procedure Delgado has performed and promoted — in spite of scant evidence of its safety and effectiveness. In the two-step process of a medication abortion, a provider first administers a dose of mifepristone and then follows it with a dose of misoprostol. Delgado claims he can intervene in a medication abortion so that the patient’s pregnancy can continue. If patients change their minds after the first step, Delgado claims, they can counteract the initial drug with a dose of progesterone.

For published medical literature, Delgado can claim a 2012 article he co-wrote in the Annals of Pharmacotherapy. The article describes six abortion reversal patients, four of whom, he claims, remained pregnant. Though published in a legitimate medical journal, Delgado’s findings were from a small sample of patients, none of whom were compared in a controlled study to patients who did not undergo the progesterone treatment. Moreover, not everything that’s published in medical journals is well received by the medical community. Dr. David A. Grimes, a physician formerly with the Centers for Disease Control and Prevention, calls the article “an incompletely documented collection of anecdotes.” Continue reading

Today Is Transgender Day of Remembrance and Resilience

The following guest post comes to us via Kelley Dupps, public policy manager for Planned Parenthood Advocates of Arizona.

candleNovember 20 is Transgender Day of Remembrance & Resilience — a day that honors the memory of those killed because of anti-transgender prejudice. So far this year, each week a trans woman lost her life to this violence. Targeted simply for who they were, these women should not only be remembered and celebrated but should also be fuel to power the movement that stands up for fairness and equality for trans folks.

Transgender Day of Remembrance & Resilience is also an opportunity for the trans community and our allies to share stories about pervasive crimes against trans folks and to celebrate the resilience of a community often living in the shadows. The 2014 Hate Violence Report, which documented hate crimes perpetrated against lesbian, gay, bisexual, transgender, queer, and HIV-affected individuals, showed an increase in transgender murder victims. Of the murder victims documented in this report, 80 percent were people of color, and 50 percent were transgender women. Transgender people of color were also 6 times more likely than the other groups studied to experience physical violence from police. These reports from the National Coalition of Anti-Violence Programs paint a bleak picture for the transgender community, particularly the trans women of color communities. The FBI also tracks violence against those living with HIV and is able to get a more complete picture of the violence targeted to trans communities.

Findings from the Injustice at Every Turn report, conducted by the National Center for Transgender Equality, showed alarming rates of violence and harassment experienced by the transgender community, including in educational settings, at work, during interactions with police and other authorities, at homeless shelters, when accessing public accommodations, and in jails and prisons.

At this time, 14 states, the District of Columbia, and more than 125 municipalities offer hate crimes protections that are inclusive of sexual orientation and gender identity. Arizona is not currently one of the states that protects LGBTQ people from violence and discrimination; however, several cities in Arizona do have nondiscrimination policies that protect city workers and community members: Phoenix, Tucson, Flagstaff, and Tempe.

After its signing in October 2009, the Matthew Shepard and James Byrd, Jr., Hate Crimes Prevention Act has made it a federal hate crime to assault an individual based on actual or perceived disability, gender, sexual orientation, or gender identity. This landmark legislation both mandates that the FBI track hate crimes based on anti-transgender bias and allows the Justice Department to assist in the prosecution of local hate crimes based on gender identity.

Much more needs to be done to address the level of violence and harassment targeted at transgender individuals. Please take a moment to remember those lost to violence and celebrate the resilient trans spirit. It’s time we commit to creating a world inclusive of all trans folks. Tag your own selfie and transformational message of how you would make your community safer for transgender people and post on social media with the hashtags #TransMonth and #PPAZ.

You can follow PPAA on Twitter @ppazaction and Instagram @PPAArizona.

World Prematurity Day: A Time to Reflect on the Importance of Prenatal Care

The following guest post comes to us via Edna Meza Aguirre, regional associate development director for Planned Parenthood Arizona. Edna is a native Tucsonan, bilingual and bicultural. She received her JD from the Sandra Day O’Connor College of Law and worked in the area of criminal defense for 12 years before changing careers. Edna is in her 16th year of volunteering at the University of Arizona Medical Center’s neonatal intensive care unit helping comfort newborn babies.

baby_feetThe neonatal intensive care unit (NICU) I volunteer in is among the best in the country. It is known nationwide for the cutting-edge research and techniques that not only save the life of a premature baby, but encourage that same infant to thrive.

The moment the delivery health care staff senses the as-yet unborn child is in stress, the amazing doctors, nurses, and respiratory therapists are on the scene in the delivery room. As in a well-coordinated symphony, the lifesaving process begins. Through the priceless intervention of these medical professionals, I have seen babies born blue return to a normal color. I have seen listless children born with no sign of life emerge back into this world through the medicine and touch of these professionals. I’ve seen sobbing parents struggling with this difficult reality as hospital staff explain the problem at hand with caring words and a gentle tone.

There isn’t a single parent who isn’t deeply emotionally affected by watching their vulnerable baby receive treatment.

Premature birth, also called preterm birth, occurs when a baby is born before the pregnancy has reached 37 weeks, and affects 1 out of every 10 babies born in the United States. Because the last few weeks of pregnancy are so crucial to a baby’s development, being born too early can lead to death or disabilities, such as breathing, vision, or hearing problems, as well as cerebral palsy and developmental delays. Treatment can sometimes depend on how premature the baby is. With a normal gestation period of 40 weeks, a premature baby might be born at 25 weeks, 30 weeks, etc. This time frame can be calculated easily enough with mothers who are receiving prenatal care.

There are, however, cases where the mother has received no prenatal care and doesn’t know how many weeks pregnant she is. Continue reading

Trans* Awareness Month: My Journey to Living Authentically

The following guest post comes to us via Kelley Dupps, public policy manager for Planned Parenthood Advocates of Arizona.

standwithpp picNovember is Trans* Awareness Month — an awareness focused on the lives and experiences of those who identify as trans* (the T in LGBTQ) or queer or questioning (the Q).

It’s important to point out the dubious character of the word “queer.” While used as an epithet to shame LGBTQ people, the word has been reclaimed by many members of the community as reflective of their identity. Remember, Facebook allows more than 50 ways to identify one’s identity and orientation; and for many, “queer” is seen as less restrictive than many of the other letters in the LGBTQ alphabet soup.

When we love someone, gender doesn’t matter.

Planned Parenthood historically has been there for the LGBTQ community — from supporting the early liberation movement to compassionately working with HIV/AIDS patients, to today addressing the issues continually chipping away at equality for all. Planned Parenthood continues to stand with the LGBTQ community in calling for continued equality in all aspects.

Planned Parenthood has always believed in one’s autonomy over one’s own body, identity, and decisions — and that is no different when it comes to supporting and fighting for trans equality. But what are we talking about when we say “trans*”? Identifying as transgender means that one’s own gender identity is different than the gender assigned at birth. The term “trans*” serves as an umbrella for other transgender identities, such as genderqueer and gender fluid to name a couple of examples. Many folks know of Caitlyn Jenner’s decision to come out and live her life authentically. She was honest that she could no longer fake it through life — the toll was too much on her soul. It was a sentiment that I could identify with. Continue reading

Abortion: Don’t Ask, Don’t Tell

Gloria Steinem. Photo: Tara Todras-Whitehill

Gloria Steinem. Photo: Tara Todras-Whitehill

Anyone who has followed the dramatic reversal of public opinion about same-sex marriage in particular and LGBTQ issues in general knows that a big part of that shift has been due to people coming out of the closet. Whadayaknow — these folks, nearly 2 percent of the U.S. population, were our sons, our daughters, our co-workers, our friends and acquaintances, often people we already loved, liked, or respected. It became a lot harder to hold on to old prejudices, didn’t it?

But coming out was not an option for those serving in the military. “Don’t ask, don’t tell” was the U.S. military’s 1994 policy compromise to allow gays and lesbians to serve, so long as they stayed in the closet. When repealed in 2011, what adverse effects did our armed forces experience? A study one year later showed that military life went on as usual, national security was not compromised, and a new understanding and acceptance among soldiers and sailors ensued. The media became blissfully disinterested in the non-story.

When it comes to abortion, we’re not asking, and we’re not telling.

Noodling on this “familiarity breeds understanding” idea, I began thinking that the same might be true if those of us who have had abortions came out of the closet, too. Turns out, this idea is not my own brilliant insight, but has been around for years and is gaining traction: In 2005, Jennifer Baumgardner produced a film; in 2011, Congresswoman Jackie Speier told her story on the floor of the House of Representatives; the “1 in 3” website has published hundreds of personal abortion stories since 2011; Texas state Sen. Wendy Davis revealed her previous abortions in her 2014 autobiography; #ShoutYourAbortion appeared on Twitter in September 2015.

Mostly, though, we still live in the de facto “don’t ask, don’t tell” abortion world — yes, we know abortion happens for some women out there somewhere, but we avoid divulging the details of this reality of human reproductive life. Is abortion really too unpleasant or unfortunate or shameful or embarrassing to speak of in public? If 1 in 3 women (33 percent!) has had or will have an abortion, consider how many of your lifetime circle of female acquaintances would have had an abortion. Let’s do the math: Continue reading

STD Awareness: Is Bacterial Vaginosis a Sexually Transmitted Disease?

Not to scale: Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Bacterial vaginosis, or BV, is the most common vaginal infection among people 15 to 44 years of age. It’s caused by an overgrowth of harmful bacteria, such as Gardnerella vaginalis. A healthy vagina hosts thriving populations of Lactobacillus bacteria species, but when these “good” bacteria are crowded out by certain types of “bad” bacteria, the vaginal ecosystem can be shifted, causing BV.

There is a lot of confusion about BV. Is it a sexually transmitted disease (STD)? What are the symptoms? How can you avoid it?

All good questions. Let’s examine them one by one.

Is BV an STD?

The consensus seems to be that BV isn’t officially an STD, but even reliable sources have somewhat contradictory information. Planned Parenthood doesn’t list BV as an STD on their informational webpages. The Centers for Disease Control and Prevention (CDC) does include BV on their STD website, but also says that “BV is not considered an STD.”

On the other hand, the Office on Women’s Health says that “BV can … be caused by vaginal, oral, or anal sex” and that “you can get BV from male or female partners.” And there’s an entire chapter devoted to BV in the premier medical textbook on STDs, and its authors say that, while sexually inexperienced females can get BV, “the weight of evidence supports sexual transmission” of G. vaginalis, the bacteria species most famously implicated in BV infections.

The same webpage on which the CDC declared BV not to be an STD also says that it can be transferred between female sexual partners. Indeed, women who have sex with women have higher rates of BV. Since vaginal fluid could spread BV, partners can change condoms when a sex toy is passed from one to another, and use barriers like dental dams when engaging in cunnilingus (oral contact with the female genitalia) or rimming (oral contact with the anus).

What about heterosexual transmission? Continue reading

To Mammography or Not

The following guest post comes to us via Cynthia.

questionOctober is probably one of the best examples of a public awareness campaign catching on and sticking. Maybe you already knew, thanks to the ubiquitous pink ribbons you see all around you this month, but October is National Breast Cancer Awareness Month, a time to encourage people to receive screening for the most common cancer among American women. The movement to promote breast cancer awareness has become pervasive. But for me, breast cancer is more than just a campaign — it is a disease that has become a part of my family history. And it has become personal, with numerous friends diagnosed and getting treatment, some of them before they reached the age of 35.

Contradictions regarding mammography exist within the medical community. Where did all of this put me?

When I turned 30, I talked to my doctor about my family history and the concerns I had about breast cancer. Although most health experts don’t recommend a mammography until a woman is in her 40s or 50s, she provided me with a referral to get a mammogram so that we had a baseline image for future comparison. I was anxious while I sat in the waiting room at the imaging center, but I also felt like I was being responsible and proactive when it came to my health. The mammogram was normal and it was put into my file. It wouldn’t be looked at again until I was 40, when my ob/gyn recommended that I get my next mammogram.

This October isn’t just Breast Cancer Awareness Month. It’s also the month I turned 40. I am preparing for my next mammogram, but I have questions for my doctor before I make the appointment. Is it really necessary? Can I wait to get my next mammogram? I have a lot of questions, because there was conflicting information handed down earlier this year from the U.S. Preventive Services Task Force. Continue reading